Experience, Outcomes, and Insights on Endoscopic Colonic Polyp Excision: A Retrospective Cohort Study.

Introduction Colorectal cancer (CRC) continues to pose a major public health challenge, ranking among the most common malignancies globally and being a leading cause of cancer-related mortality. Most CRCs originate from adenomatous polyps, underscoring the importance of detecting and removing these precancerous growths as a key preventive measure against CRC. In particular, large colonic polyps (≥10 mm) warrant special attention due to their increased risk of progressing to malignancy compared to smaller polyps. This retrospective study aims to evaluate the outcomes of large polyp excision within a single NHS trust. By analysing patient demographics, polyp characteristics, procedural details, and clinical outcomes, this study seeks to provide comprehensive data on the efficacy and safety of endoscopic polyp excision. Patients and methods This retrospective cohort study was conducted at Maidstone and Tunbridge Wells NHS Trust, a district general hospital in Tunbridge Wells, England, with data collected for all patients who had endoscopic polypectomy from 2010 to 2022. Data collected from medical records included age, sex, polyp size and characteristics, and previous polyp removal attempts. Results A total of 350 participants were included in this study. The cohort comprised 224 males (64%) and 126 females (36%), with a mean age of 70 ± 12 years. Complications were observed in eight participants (2.3%), while 340 participants (97.7%) did not experience any complications. Participants who experienced complications had a mean polyp size of 49.38 ± 7.3 mm, whereas those without complications had a mean polyp size of 44.85 ± 16.5 mm (p = 0.440). All complications occurred in participants with polyps ≥40 mm. However, this association was not statistically significant (p = 0.352). Conclusion Our study has shown that large polyps can be safely excised in a local district hospital. The incidence of complications is related to the polyp size. A cutoff size of 40 mm was found to be related to increased complications. However, this was still statistically insignificant and won't affect the efficacy and safety of these procedures being carried out in a local district hospital, decreasing the load on tertiary and specialised hospitals.