ACCESSIBILITY TO ENDOSCOPIC RESECTION OF COLORECTAL NEOPLASTIC LESIONS≥20MM IN A REFERRAL CENTER: WHAT WAS THE COVID-19 PANDEMIC IMPACT?

Aims Advanced endoscopic resection (ER) for complex colorectal polyps is accessible only in referral centers. Accessibility is not yet stated in quality European guidelines for colonoscopy.

We aim to compare ER scheduling with lesion’s histology and evaluate the COVID-19 pandemic impact.

Methods Retrospective study including patients with colorectal neoplastic lesions≥20mm, scheduled for ER in a Gastroenterology referral department, from September/2019 to September/2021, comparing the pre-pandemic period (until March 18^th, 2020) with COVID-19 pandemic period. Histology was classified as no dysplasia/low-grade dysplasia versus high-grade dysplasia/carcinoma (high-risk lesions).

Results Included 143 patients (47 in the pre-pandemic group versus 96 in the pandemic period), corresponding to 156 lesions. Sixty-three (40.4%) were high-risk lesions. [Table 1] describes overall population’s characteristics.

There was no statistically significant difference between gender, age and referral origin when compared to histology (p=0.383, 0.744 and 0.602, respectively). The referral-scheduling interval was similar in both histologic groups (108 vs 95 days, p=0.129). Scheduling delay over 60 and 90 days did not correlate with advanced histology (p=0.369 and p=0.414, respectively).

There was no significant difference between referral-scheduling delay in the pre and pandemic periods (98 vs 100 days, p=0.525). High-risk histology was not more frequent in the pandemic period (p=0.858).

Table 1

Male gender	89 (62.2%)
Age (mean±SD, range, in years)	70.4±11.3 (28-92)
Outpatient referral	86 (60.1%)
Days between diagnosis and ER scheduling (median, IQR;min-max)	100 (89;2-248)

Conclusions Neither the histological outcome nor the ER scheduling delay were significantly impacted during the COVID-19 pandemic in our unit. Further studies are needed to consider ER accessibility as an additional quality criterion.

Publication History

Article published online:
14 April 2022