Use of a novel polyp "ruler snare" improves estimation of colon polyp size.
Gastrointest Endosc
; 83(4): 812-6, 2016 Apr.
Article
en En
| MEDLINE
| ID: mdl-26382052
ABSTRACT
BACKGROUND AND AIMS:
Prior studies have demonstrated that endoscopists' estimates of polyp size are imprecise. The aim of this study was to determine whether a modified polypectomy "ruler snare" improves the accuracy of assessment of polyp size in real time without the use of additional devices.METHODS:
Ten artificial polyps of predetermined sizes (4 to 25 mm) were affixed to the inside of a colon model. A standard polypectomy snare was modified by adding 5-mm graduated markings to the distal end of the plastic sheath. Study participants estimated the sizes of the artificial polyps during simulated colonoscopies, first using a standard snare and then with the modified ruler snare.RESULTS:
Thirty-four private practice and academic gastroenterologists participated in the study. Endoscopists' ability to accurately classify polyps by size (diminutive, small, or large) improved from 48.5% to 60.3% with the ruler snare (P = .002). The greatest improvement in precision was seen among the large polyps, where accuracy increased from 35.9% to 58.2% with use of the ruler snare (P < .0001). Participants underestimated polyp size by a mean of 3.6 mm (interquartile range, -5 to -2 mm) with the standard snare and 1.8 mm (interquartile range, -3 to 0 mm) with the ruler snare, which corresponded to a 44.2% improvement in accuracy with the ruler snare (P < .05).CONCLUSIONS:
The modified ruler snare improved polyp size assessment compared with a standard snare, particularly with large polyps. Overall, although size estimation continues to be imprecise, the addition of calibrated markings to a polypectomy snare is a simple and likely low-cost means to improve neoplasia surveillance recommendations.
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Base de datos:
MEDLINE
Asunto principal:
Pólipos del Colon
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Colonoscopía
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Carga Tumoral
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Precisión de la Medición Dimensional
Tipo de estudio:
Guideline
Idioma:
En
Revista:
Gastrointest Endosc
Año:
2016
Tipo del documento:
Article