A123 THE EFFECTS OF INFLAMMATORY BOWEL DISEASE ON THE MANAGEMENT AND OUTCOMES OF COMPLEX POLYPS IN PATIENTS UNDERGOING SURVEILLANCE COLONOSCOPY: A RETROSPECTIVE COHORT STUDY

TL;DR

This study found that inflammatory bowel disease does not significantly affect the management or outcomes of complex polyps during colonoscopies.

Contribution

The study is one of the few to investigate the specific impact of IBD on complex polyp management and outcomes in surveillance colonoscopies.

Findings

Patients with IBD were younger but had similar rates of complete polyp removal and surgical intervention compared to non-IBD patients.

IBD patients were more likely to be managed by gastroenterologists than other endoscopists.

Non-IBD patients had more complex polyps in difficult locations.

Abstract

The influence of inflammatory bowel disease (IBD) on the outcomes of complex polyps remains an area of uncertainty.

To investigate the impact of IBD on the management and outcomes of complex polyps during surveillance colonoscopy.

This retrospective cohort study utilized a prospectively collected database, involving patients who underwent surveillance colonoscopy for colorectal cancer or IBD surveillance who were identified to have complex polyps between February 2019 and December 2020 in Southwestern Ontario. Patient demographics, disease characteristics, medication history, polyp description and management were analyzed. The data were summarized in median and interquartile range for continuous variable and frequency and percentage for categorical variables. Characteristics between IBD and non-IBD were compared using the Wilcoxon rank sum test and Fisher’s exact test, as appropriate.

383 patients were included in the study, of which 27 individuals had IBD (5 Crohn's disease, 13 ulcerative colitis, and 9 indeterminate colitis). Patients with IBD were generally younger than their non-IBD counterparts (median age 61 vs 67 respectively). No significant differences were identified in terms of rates of complete polyp removal (17.70 % vs 22.22 %, pampersand:003C0.602), residual polyps after resection (76.97% vs 70.37%, pampersand:003C0.476), repeat removal attempts (84.27% vs 74.07%, pampersand:003C0.179), or surgical intervention (88.76% vs 88.89%, pampersand:003C0.99). A higher proportion of IBD patients were managed by gastroenterologists vs other endoscopists (81.48% vs. 40.17%, p ampersand:003C 0.001). No significant differences in complex polyp characteristics were observed, except in difficult locations of complex polyps were more common in the non-IBD cohort (55.34% vs 25.93%, pampersand:003C0.004).

In this retrospective cohort study, IBD does not appear to influence the management or outcome of complex polyps. Larger studies are required given the small IBD cohort size in this study.

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