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Establishment of standards for the referral of large nonpedunculated colorectal polyps: an international expert consensus using a modified Delphi process.
Khalaf, Kareem; Seleq, Samir; Bourke, Michael J; Alkandari, Asma; Bapaye, Amol; Bechara, Robert; Calo, Natalia C; Fedorov, Evgeniy D; Hassan, Cesare; Kalauz, Mirjana; Kandel, Gabor P; Matsuda, Takahisa; May, Gary R; Mönkemüller, Klaus; Mosko, Jeffrey D; Ohno, Akiko; Pavic, Tajana; Pellisé, Maria; Raos, Zoe; Repici, Alessandro; Rex, Douglas K; Saxena, Payal; Schauer, Cameron; Sethi, Amrita; Sharma, Prateek; Shaukat, Aasma; Siddiqui, Uzma D; Singh, Rajvinder; Smith, Lesley-Ann; Tanabe, Mayo; Teshima, Christopher W; von Renteln, Daniel; Gimpaya, Nikko; Pawlak, Katarzyna M; Angeli Fujiyoshi, Mary Raina; Fujiyoshi, Yusuke; Lamba, Mehul; Li, Suqing; Malipatil, Sharan B; Grover, Samir C.
Affiliation
  • Khalaf K; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Seleq S; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Bourke MJ; Westmead Hospital University of Sydney, Sydney, New South Wales, Australia.
  • Alkandari A; Thanyan Alghanim Center for Gastroenterology and Hepatology, Alamiri Hospital, Kuwait City, Kuwait.
  • Bapaye A; Shivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Pune, Maharashtra, India.
  • Bechara R; Division of Gastroenterology, Department of Medicine, Queen's University, Kingston, Ontario, Canada.
  • Calo NC; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Fedorov ED; Pirogov Russia National Research Medical University, Moscow, Russian Federation.
  • Hassan C; Endoscopy Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy.
  • Kalauz M; Department of Internal Medicine, Division of Gastroenterology and Hepatology, University Hospital Centre Zagreb, Zagreb, Croatia.
  • Kandel GP; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Matsuda T; Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan.
  • May GR; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Mönkemüller K; Department of Gastroenterology, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA.
  • Mosko JD; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Ohno A; Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan.
  • Pavic T; Department of Gastroenterology and Hepatology, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia.
  • Pellisé M; Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
  • Raos Z; Department of Gastroenterology, Te Whatu Ora-Waitemata, Faculty of Medicine, The University of Auckland, Auckland, New Zealand.
  • Repici A; Endoscopy Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy.
  • Rex DK; Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
  • Saxena P; AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
  • Schauer C; Department of Gastroenterology, Te Whatu Ora-Waitemata, Faculty of Medicine, The University of Auckland, Auckland, New Zealand.
  • Sethi A; Division of Digestive and Liver Disease, Irving Medical Center, Columbia University, New York, New York, USA.
  • Sharma P; University of Kansas School of Medicine, VA Medical Center, Kansas City, Kansas, USA.
  • Shaukat A; Division of Gastroenterology, Department of Medicine, NYU Grossman School of Medicine, New York City, New York, USA.
  • Siddiqui UD; Center for Endoscopic Research and Therapeutics (CERT), University of Chicago, Chicago, Illinois, USA.
  • Singh R; Lyell McEwin Hospital, NALHN & the University of Adelaide, Adelaide, South Australia, Australia.
  • Smith LA; Department of Gastroenterology, Te Whatu Ora-Waitemata, Faculty of Medicine, The University of Auckland, Auckland, New Zealand.
  • Tanabe M; Showa University Koto Toyosu Hospital, Digestive Diseases Center, Tokyo, Japan.
  • Teshima CW; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • von Renteln D; Centre Hospitalier de l'Universite de Montreal (CHUM), Universite de Montreal, Montreal, Quebec, Canada.
  • Gimpaya N; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Pawlak KM; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Angeli Fujiyoshi MR; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Fujiyoshi Y; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Lamba M; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Li S; Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Malipatil SB; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
  • Grover SC; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada; Scarborough Health Network, Toronto, Ontario, Canada. Electronic address: samir.grover@utoronto.ca.
Gastrointest Endosc ; 100(3): 510-516.e6, 2024 Sep.
Article in En | MEDLINE | ID: mdl-38331224
ABSTRACT
BACKGROUND AND

AIMS:

Resection of colorectal polyps has been shown to decrease the incidence and mortality of colorectal cancer. Large nonpedunculated colorectal polyps are often referred to expert centers for endoscopic resection, which requires relevant information to be conveyed to the therapeutic endoscopist to allow for triage and planning of resection technique. The primary objective of this study was to establish minimum expected standards for the referral of large nonpedunculated colonic polyps for potential endoscopic resection.

METHODS:

A Delphi method was used to establish consensus on minimum expected standards for the referral of large colorectal polyps among a panel of international endoscopy experts. The expert panel was recruited through purposive sampling, and 3 rounds of surveys were conducted to achieve consensus. Quantitative and qualitative data were analyzed for each round.

RESULTS:

A total of 24 international experts from diverse continents participated in the Delphi study, resulting in consensus on 19 statements related to the referral of large colorectal polyps. The identified factors, including patient demographic characteristics, relevant medications, lesion factors, photodocumentation, and the presence of a tattoo, were deemed important for conveying the necessary information to therapeutic endoscopists. The mean scores for the statements, which were scored on a scale of 1 to 10, ranged from 7.04 to 9.29, with high percentages of experts considering most statements as a very high priority. Subgroup analysis according to continent revealed some variations in consensus rates among experts from different regions.

CONCLUSIONS:

The identified consensus statements can aid in improving the triage and planning of resection techniques for large colorectal polyps, ultimately contributing to the reduction of colorectal cancer incidence and mortality.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Referral and Consultation / Colonic Polyps / Delphi Technique / Colonoscopy / Consensus Type of study: Guideline / Prognostic_studies / Qualitative_research Limits: Humans Language: En Journal: Gastrointest Endosc Year: 2024 Document type: Article Affiliation country: Canada Country of publication: United States
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Referral and Consultation / Colonic Polyps / Delphi Technique / Colonoscopy / Consensus Type of study: Guideline / Prognostic_studies / Qualitative_research Limits: Humans Language: En Journal: Gastrointest Endosc Year: 2024 Document type: Article Affiliation country: Canada Country of publication: United States