Accuracy of endoscopists' estimate of polyp size: A continuous dilemma

作     者：Manhal Izzy Muhammad Asif Virk Avi Saund Juan Tejada Faraj Kargoli Sury Anand 

作者机构：Division of Gastroenterology the Brooklyn Hospital Center/New York Presbyterian Health Care System Division of Gastroenterology and Liver DiseasesMontefiore Medical Center 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2015年第7卷第8期

页      面：824-829页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Polyp size estimate Colonic polyps Endoscopistestimate 

摘      要：AIM: To examine the discrepancy, if any, between the endoscopist s estimate and pathologist s measurement of colonic polyp size. METHODS: We retrospectively studied 88 patients who underwent colonoscopy with a clear unequivocal documentation of polyp size by both the endoscopist and pathologist. Endoscopist measurements were based on the visual estimate of polyp size seen on high definition screens. The measurement was done by our pathologists after formalin fixation. We compared the endoscopist estimate of the polyp size to the pathologist measurement in order to explore the discordance between the two readings. Data regarding demographics and method of polypectomy(snare polypectomy vs excisional biopsy) was collected, as well. Statistical analysis software statistical software was used to analyze the data. RESULTS: Our cohort included 88 patients from which 111 polyps were removed. Fifty-two(46.8%) of the 111 polyps were excised using biopsy forceps and fiftynine(53.2%) were removed by snare. In the biopsy forceps group, the mean polyp size documented by the pathologist was 0.38 ± 0.19 cm and the mean polyp size documented by the endoscopist was 0.54 ± 0.16cm. The mean difference was 0.15 cm(P 0.001). In the snare group, the mean polyp size documented by the pathologist was 0.54 ± 0.24 cm and the mean polyp size documented by the endoscopist 0.97 ± 0.34 cm. The mean difference was 0.42 cm(P 0.001). Combining both groups, the mean size documented by pathologist was 0.46 ± 0.23 cm compared to 0.76 ± 0.35 cm documented by the endoscopist. The mean difference was 0.3 cm(95%CI: 0.23-0.36).CONCLUSION: Post polypectomy measurement by the pathologist are generally smaller than the endoscopist s estimate.