Endoscopy 2020; 52(S 01): S14-S15
DOI: 10.1055/s-0040-1704051
ESGE Days 2020 oral presentations
Friday, April 24, 2020 08:30 – 10:30 Endoscopy in flames Liffey Hall 1
© Georg Thieme Verlag KG Stuttgart · New York

SESSILE SERRATED LESIONS IN INFLAMMATORY BOWEL DISEASE - A RETROSPECTIVE STUDY IN A TERTIARY CENTRE

A Dhillon
1   St Mark’s Hospital, Wolfson Unit for Endoscopy, London, United Kingdom
,
A Wilson
1   St Mark’s Hospital, Wolfson Unit for Endoscopy, London, United Kingdom
2   Imperial College London, Department of Surgery and Cancer, London, United Kingdom
,
N Suzuki
1   St Mark’s Hospital, Wolfson Unit for Endoscopy, London, United Kingdom
,
M Choy
1   St Mark’s Hospital, Wolfson Unit for Endoscopy, London, United Kingdom
3   University of Melbourne, Austin Academic Centre, Department of Medicine, Melbourne, Australia
,
S Thomas-Gibson
1   St Mark’s Hospital, Wolfson Unit for Endoscopy, London, United Kingdom
2   Imperial College London, Department of Surgery and Cancer, London, United Kingdom
,
BP Saunders
1   St Mark’s Hospital, Wolfson Unit for Endoscopy, London, United Kingdom
2   Imperial College London, Department of Surgery and Cancer, London, United Kingdom
,
A Latchford
1   St Mark’s Hospital, Wolfson Unit for Endoscopy, London, United Kingdom
2   Imperial College London, Department of Surgery and Cancer, London, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Sessile serrated lesions (SSLs) are increasingly recognised at colonoscopy. However, their significance in inflammatory bowel disease (IBD) is unclear. We examined the clinicopathological features and outcome of IBD patients with SSLs.

Methods Patients undergoing IBD surveillance colonoscopy from November 2008-2018 were identified. Patients with polyposis syndromes and previous colorectal surgery were excluded. 1003 patients were included. Demographics and procedural data including histology reports were reviewed.

Results Forty-eight patients with IBD had 61 SSLs (ulcerative colitis n=46, Crohn’s colitis n=2). Twenty-six patients (54%) were female. The median age at identification of index SSL was 63 years (range 26-81). Thirty-one (65%) patients had pancolitis. Thirty-eight (62%) SSLs were in the right colon and 13 (21%) were found outside an area of previously inflamed bowel. Thirty-six patients (75%) had no previous history of dysplasia.

The median SSL size was 8mm (range 2-37mm) and 49 (80%) had Paris IIa morphology. Dysplasia was present in 17 (28%) SSLs. SSLs with dysplasia were significantly larger than SSLs without dysplasia (mean size 14mm v 8mm, p = 0.003).

Fifty-nine SSLs were endoscopically resected with no reported adverse events: cold biopsy (4), cold snare (37), EMR (15), ESD (3). Twelve SSLs with dysplasia (71%) were endoscopically resected en-bloc.

Twelve patients (25%) had synchronous dysplasia, two of which underwent colectomy due to high grade dysplasia and adenocarcinoma respectively. Follow up endoscopic data was available for 29 patients over a median (IQR) duration of 3 years (2-4), with metachronous dysplasia occurring in 12 patients (41%), of which eight were multifocal.

Conclusions Rates of dysplasia in IBD SSLs are higher in our cohort than reported in sporadic SSLs/serrated polyposis. High rates of metachronous dysplasia were seen in IBD patients with SSLs. Further studies are required to investigate if SSLs in IBD are associated with increased risk of advanced neoplasia.