P1044 - General versus Interventional Gastroenterologists: Comparative Analysis of Follow-Up Outcomes for Endoscopic Mucosal Resection of Colorectal Polyps

Mahmoud Y. Madi, MD¹, Hayden Rotramel, MD², Yassine Kilani, MD¹, Michelle Baliss, DO¹, Gregory Sayuk, MD³, Jill E. Elwing, MD³, Ahmad Najdat Bazarbashi, MD^4
1SSM Health Saint Louis University Hospital, St. Louis, MO; ²SSM Health St. Louis University Hospital, St. Louis, MO; ³Washington University School of Medicine in St. Louis, St. Louis, MO; ⁴Washington University School of Medicine in St. Louis / Barnes-Jewish Hospital, St. Louis, MO

Introduction: Close follow-up after endoscopic mucosal resection (EMR) of colorectal polyps is essential given the relatively high polyp recurrence rates reported in the literature. Presently, there is a gap in understanding whether there are differences in outcomes of post-EMR follow-up when conducted by general gastroenterologists compared to interventional gastroenterologists.

Methods: We conducted a single center retrospective study of adult patients presenting for follow-up after undergoing colorectal polyp EMR between January 2019 and December 2022. Pre-defined variables extracted from the electronic medical record were then analyzed to discern significant differences in outcomes between general and interventional gastroenterologists utilizing a combination of Pearson’s Chi-square and logistic regression as appropriate.

Results: A total of fifty-nine (N=59) patients (mean age 66.5 +/- 6.6 years, 10% females, 16% African American) met the inclusion criteria for our study. Baseline characteristics of included patients are described in Table 1. General gastroenterologists were more likely to biopsy the EMR site compared to interventional gastroenterologists (65% vs 40%, p=0.04). There was no significant difference in overall pathology detected on EMR site biopsy when comparing general and interventional gastroenterologists (p=0.07). When the EMR site was biopsied (N=43), pathology review showed normal scar tissue in 14 patients (32.6%), hyperplastic changes in 10 patients (23.3%), tubular adenoma in 9 patients (20.9%), tubulovillous adenoma in 9 patients (20.9%), and adenocarcinoma in 1 patient (2.3%). No significant differences were found between general gastroenterologists and interventional gastroenterologists when comparing procedural Boston Bowel Preparation Score, number of polyps detected, detection of residual tissue at EMR site, EMR site recurrence requiring polypectomy, or recommended surveillance interval.

Discussion: Our study provides evidence that the outcomes of post-EMR follow-up are largely comparable between general and interventional gastroenterologists. Although general gastroenterologists exhibit higher rates of EMR site biopsy, the detected pathologies show no significant difference. Though confirmation of these findings is warranted, our observations suggest that post-EMR follow-up by general gastroenterologists may be appropriate, particularly in resource-limited setting.


Disclosures:


Mahmoud Y. Madi, MD¹, Hayden Rotramel, MD², Yassine Kilani, MD¹, Michelle Baliss, DO¹, Gregory Sayuk, MD³, Jill E. Elwing, MD³, Ahmad Najdat Bazarbashi, MD⁴. P1044 - General versus Interventional Gastroenterologists: Comparative Analysis of Follow-Up Outcomes for Endoscopic Mucosal Resection of Colorectal Polyps, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.