A97 LARGE NON-PEDUNCULATED COLONIC POLYP (LNPCP) OUTCOMES REFERRED FOR ENDOSCOPIC RESECTION IN BRITISH COLUMBIA: A QUALITY ASSURANCE INITIATIVE

Abstract Background Endoscopic resection techniques have become the primary treatment strategy for vast majority of large (≥ 20mm) non-pedunculated colonic polyps (LNPCPs). Despite this, surgery is still commonly performed with evidence suggesting an increasing trend over time. There limited Canadian data confirming effectiveness and safety endoscopic management LNPCPs. Purpose To investigate clinical outcomes patients referred a LNPCP. Method Retrospective single-centre analysis to single endoscopist LNPCPs within tertiary referral practice. were further subdivided into non-complicated (NC-LNPCP) or complicated (C-LNPCP) defined as those involving ileocecal valve, appendiceal orifice, circumferential previously attempted. Performance evaluated by frequencies technical success (removal all polypoid tissue during index procedure) need colorectal surgery. Safety was clinically significant intraprocedural bleeding (CSIPB), post-endoscopic (CSPEB), intra-procedural perforation delayed perforation. Recurrence (either histologic) at first surveillance colonoscopy (SC1). Continuous variables summarized using median (IQR). Categorical (%). test association between categorical variables, Pearson χ2 Fisher exact used, where appropriate. For continuous Mann-Whitney U used. A probability (p) value <0.05 considered statistically significant. Result(s) Between January 2021 March 2022, 263 LNPCP 41 excluded (23 pedunculated, 14 optical evaluation suggestive deeply invasive cancer, 4 other). 222 (188 NC-LNPCP, 34 C-LNPCP) underwent resection. Median size 25mm (IQR 20-30mm) undergoing cold snare (115, 51.8%). Polyposis (Adenomatous serrated) present in 23 (12.6%) cases respectively. Technical 97.3%. Cancer 5 (2%). Clinically (CSPEB) occurred 2.7%, DMI IV 1.8% there no perforations. (3.5%) SC1 11 (5%) required due failure, submucosal invasion on pathology bleeding. Image Conclusion(s) offers safe effective alternative British Columbia. Please acknowledge funding agencies checking applicable boxes below None Disclosure Interest Declared