AIM: To determine the accuracy of endoscopic polyp size measurements using disposable graduated biopsy forceps(DGBF). METHODS: Gradations accurate to 1 mm were assessed with the wire of disposable graduated biopsy for...AIM: To determine the accuracy of endoscopic polyp size measurements using disposable graduated biopsy forceps(DGBF). METHODS: Gradations accurate to 1 mm were assessed with the wire of disposable graduated biopsy forceps. When a polyp was noted, endoscopists determined the width of the polyp; then, the graduated biopsy forceps was inserted and the largest diameter of the tumor was measured. After excision, during surgery or endoscopy, the polyp was measured using the vernier caliper.RESULTS: One hundred and thirty-three colorectal polyps from 119 patients were studied. The mean diameter, by post-polypectomy measurement, was 0.92 ± 0.69 cm; 83 were < 1 cm, 36 were between 1 and 2 cm, and 14 were > 2 cm. The mean diameter, by visual estimation, was 1.15 ± 0.88 cm; compared to the actual size measured using vernier calipers, the difference was statistically significant. The mean diameter measured using the DGBF was 0.93 ± 0.68 cm; compared to the actual size measured using vernier calipers, this difference was not statistically significant. The ratio between the mean size estimated by visual estimation and the actual size was significantly different from that between the mean size estimated using the DGBF and the actual size(1.26 ± 0.30 vs 1.02 ± 0.11).CONCLUSION: The accuracy of polyp size estimation was low by visual assessment; however, it improved when the DGBF was used.展开更多
AIM: To examine the discrepancy, if any, between the endoscopist's estimate and pathologist's measurement of colonic polyp size. METHODS: We retrospectively studied 88 patients who underwent colonoscopy with a...AIM: To examine the discrepancy, if any, between the endoscopist's estimate and pathologist's measurement of colonic polyp size. METHODS: We retrospectively studied 88 patients who underwent colonoscopy with a clear unequivocal documentation of polyp size by both the endoscopist and pathologist. Endoscopist measurements were based on the visual estimate of polyp size seen on high definition screens. The measurement was done by our pathologists after formalin fixation. We compared the endoscopist estimate of the polyp size to the pathologist measurement in order to explore the discordance between the two readings. Data regarding demographics and method of polypectomy(snare polypectomy vs excisional biopsy) was collected, as well. Statistical analysis software statistical software was used to analyze the data. RESULTS: Our cohort included 88 patients from which 111 polyps were removed. Fifty-two(46.8%) of the 111 polyps were excised using biopsy forceps and fiftynine(53.2%) were removed by snare. In the biopsy forceps group, the mean polyp size documented by the pathologist was 0.38 ± 0.19 cm and the mean polyp size documented by the endoscopist was 0.54 ± 0.16cm. The mean difference was 0.15 cm(P < 0.001). In the snare group, the mean polyp size documented by the pathologist was 0.54 ± 0.24 cm and the mean polyp size documented by the endoscopist 0.97 ± 0.34 cm. The mean difference was 0.42 cm(P < 0.001). Combining both groups, the mean size documented by pathologist was 0.46 ± 0.23 cm compared to 0.76 ± 0.35 cm documented by the endoscopist. The mean difference was 0.3 cm(95%CI: 0.23-0.36).CONCLUSION: Post polypectomy measurement by the pathologist are generally smaller than the endoscopist's estimate.展开更多
Detection of polypoid lesions of the gallbladder is increasing in conjunction with better imaging modalities. Accepted management of these lesions depends on their size and symptomatology. Polyps that are symptomatic ...Detection of polypoid lesions of the gallbladder is increasing in conjunction with better imaging modalities. Accepted management of these lesions depends on their size and symptomatology. Polyps that are symptomatic and/or greater than 10 mm are generally removed, while smaller, asymptomatic polyps simply monitored. Here, a case of carcinoma-in-situ is presented in a 7 mm gallbladder polyp. A 25-year-old woman, who had undergone a routine cholecystectomy, was found to have an incidental 7 mm polyp containing carcinoma in situ. She had few to no risk factors to alert to her condition. There are few reported cases of cancer transformation in gallbladder polyps smaller than 10 mm reported in the literature. The overwhelming consensus, barring significant risk factors for cancer being present, is that such lesions should be monitored until they become symptomatic or develop signs suspicious for malignancy. In our patient's case this could have led to the possibility of missing a neoplastic lesion, which could then have gone on to develop invasive cancer. As gallbladder carcinoma is an aggressive cancer, this may have led to a tragic outcome.展开更多
基金Supported by National Nature Science Foundation of China,No.3097383 and No.81273944grants from The Nanjing Medical Technology Development Project,No.NJYX201203
文摘AIM: To determine the accuracy of endoscopic polyp size measurements using disposable graduated biopsy forceps(DGBF). METHODS: Gradations accurate to 1 mm were assessed with the wire of disposable graduated biopsy forceps. When a polyp was noted, endoscopists determined the width of the polyp; then, the graduated biopsy forceps was inserted and the largest diameter of the tumor was measured. After excision, during surgery or endoscopy, the polyp was measured using the vernier caliper.RESULTS: One hundred and thirty-three colorectal polyps from 119 patients were studied. The mean diameter, by post-polypectomy measurement, was 0.92 ± 0.69 cm; 83 were < 1 cm, 36 were between 1 and 2 cm, and 14 were > 2 cm. The mean diameter, by visual estimation, was 1.15 ± 0.88 cm; compared to the actual size measured using vernier calipers, the difference was statistically significant. The mean diameter measured using the DGBF was 0.93 ± 0.68 cm; compared to the actual size measured using vernier calipers, this difference was not statistically significant. The ratio between the mean size estimated by visual estimation and the actual size was significantly different from that between the mean size estimated using the DGBF and the actual size(1.26 ± 0.30 vs 1.02 ± 0.11).CONCLUSION: The accuracy of polyp size estimation was low by visual assessment; however, it improved when the DGBF was used.
文摘AIM: To examine the discrepancy, if any, between the endoscopist's estimate and pathologist's measurement of colonic polyp size. METHODS: We retrospectively studied 88 patients who underwent colonoscopy with a clear unequivocal documentation of polyp size by both the endoscopist and pathologist. Endoscopist measurements were based on the visual estimate of polyp size seen on high definition screens. The measurement was done by our pathologists after formalin fixation. We compared the endoscopist estimate of the polyp size to the pathologist measurement in order to explore the discordance between the two readings. Data regarding demographics and method of polypectomy(snare polypectomy vs excisional biopsy) was collected, as well. Statistical analysis software statistical software was used to analyze the data. RESULTS: Our cohort included 88 patients from which 111 polyps were removed. Fifty-two(46.8%) of the 111 polyps were excised using biopsy forceps and fiftynine(53.2%) were removed by snare. In the biopsy forceps group, the mean polyp size documented by the pathologist was 0.38 ± 0.19 cm and the mean polyp size documented by the endoscopist was 0.54 ± 0.16cm. The mean difference was 0.15 cm(P < 0.001). In the snare group, the mean polyp size documented by the pathologist was 0.54 ± 0.24 cm and the mean polyp size documented by the endoscopist 0.97 ± 0.34 cm. The mean difference was 0.42 cm(P < 0.001). Combining both groups, the mean size documented by pathologist was 0.46 ± 0.23 cm compared to 0.76 ± 0.35 cm documented by the endoscopist. The mean difference was 0.3 cm(95%CI: 0.23-0.36).CONCLUSION: Post polypectomy measurement by the pathologist are generally smaller than the endoscopist's estimate.
文摘Detection of polypoid lesions of the gallbladder is increasing in conjunction with better imaging modalities. Accepted management of these lesions depends on their size and symptomatology. Polyps that are symptomatic and/or greater than 10 mm are generally removed, while smaller, asymptomatic polyps simply monitored. Here, a case of carcinoma-in-situ is presented in a 7 mm gallbladder polyp. A 25-year-old woman, who had undergone a routine cholecystectomy, was found to have an incidental 7 mm polyp containing carcinoma in situ. She had few to no risk factors to alert to her condition. There are few reported cases of cancer transformation in gallbladder polyps smaller than 10 mm reported in the literature. The overwhelming consensus, barring significant risk factors for cancer being present, is that such lesions should be monitored until they become symptomatic or develop signs suspicious for malignancy. In our patient's case this could have led to the possibility of missing a neoplastic lesion, which could then have gone on to develop invasive cancer. As gallbladder carcinoma is an aggressive cancer, this may have led to a tragic outcome.
