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Metachronous Neoplasia & Incomplete Polyp Resection

Clin Gastroenterol Hepatol; ePub 2019 Feb 12; Adler, et al

In a retrospective study of patients who initially underwent resection of a large (10‒20 mm) neoplastic polyp and then underwent a subsequent colonoscopy within 0.5 to 5 years, researchers estimated that 13% of all large polyps were incompletely resected and 18% of large non-pedunculated polyps were incompletely resected. The study included 1,031 patients (6,186 colon segments) from 2 academic medical centers. Researchers determined the proportions of metachronous neoplasia in colon segments from which a single large neoplastic polyp was removed and in segments without neoplasia. They used the absolute difference in proportions between the groups to estimate the rate of incomplete resection. They found:

  • Metachronous neoplasia was detected in 177 of 757 (23.4%) segments with a single large polyp, and in 428 or 4,232 (10.3%) segments without any neoplasia at baseline colonoscopy.
  • Resections were estimated to be incomplete in 13.0% of segments.
  • This proportion was greater for sections with non-pedunculated polyps than pedunculated polyps (18.3% vs 3.5%).


Adler J, Toy D, Anderson JC, Robertson DJ, Pohl H. Metachronous neoplasias arise in a higher proportion of colon segments from which large polyps were previously removed, and can be used to estimate incomplete resection of 10‒20 mm colorectal polyps. [Published online ahead of print February 12, 2019]. Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2019.01.047.