Endoscopy 2021; 53(S 01): S155
DOI: 10.1055/s-0041-1724675
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The Detect-and-Leave Strategy for Diminutive Polyps of the Recto-Sigmoid: Feasibility And Limits

Authors

  • A Hassine

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • A Hammami

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • F Zinelabidine

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • W Dahmani

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • W Ben Ameur

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • N Elleuch

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • A Ben Slama

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • M Ksiaa

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • A Braham

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • S Ajmi

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • H Jaziri

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia

  • A Jmaa

    1   University of Sousse, Faculty of Medecine of Sousse, Gastroenterology, Sahloul, Tunisia
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Aims The treatment of distal diminutive polyps less than 5 mm in size remains a global challenge for endoscopists. The aim of our study was to evaluate the feasibility of “detect-and-leave “strategy by investigating the prevalence of advanced histological signs in diminutive polyps of the recto-sigmoid.

Methods A retrospective study was conducted between 2016 and 2020, including patients who had colonoscopy with polypectomy. Two groups were defined: Group 1 for diminutive polyps located on the recto-sigmoid, and group 2 for diminutive polyps located on the other segments. Endoscopic and histopathological data were analyzed.

Results We included 223 patients with 282 polyps. The mean age was 62.28 years [33 – 86 years] with male to female ratio of 2.37. Depending on the size, polyps were classified: diminutive (≤ 5 mm, 50.2 %, n = 112), small and medium (6 – 9 mm, 34.5 %, n = 77), large (10 – 19 mm, 9.9 %, n = 22), giants (≥ 20 mm, 5.4 %, n = 12). 61.6 % of the diminutive polyps (n = 69) were located on the rectosigmoid. In the first group, polyps were adenomatous in 53.6 % of cases (all of them were tubulo-villous), hyperplastic (36.2 % of cases) or carcinomatous (1.4 % of cases). Dysplasia was found in 53.6 % of cases including 5.4 % of high grade. In the second group, polyps were adenomatous (83.7 %, all of them tubule-villous) or hyperplastic (14 %). No carcinomatous polyp was found in this group. Dysplasia was detected in 83.7 % of cases including 2.77 % of high grade. The diagnosis of adenomas was less frequent in the group of diminutive polyps of the recto-sigmoid with a statistically significant difference (p = 0.001).

Conclusions Our study has shown a significant rate of advanced histological signs within diminutive polyps of the recto- sigmoid. Thus,“detect-and-leave” strategy can only be applied in expert centers where advanced endoscopy techniques are available.

Citation: Hassine A, Hammami A, Zinelabidine F et al. eP179 THE DETECT-AND-LEAVE STRATEGY FOR DIMINUTIVE POLYPS OF THE RECTO-SIGMOID: FEASIBILITY AND LIMITS. Endoscopy 2021; 53: S155.



Publication History

Article published online:
19 March 2021

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