Mohamed Elmasry, DO, Khushboo Gala, MD, Wenjing Cai, MD, Scott Diamond, MD, Amal Shine, MD, David Liu, MD, Nanlong Liu, MD, Don Ramesh Tholkage, MD, Maiying Kong, PhD, Craig McClain, MD, Dipendra Parajuli, MD; University of Louisville, Louisville, KY
Introduction: Laterally spreading Lesions (LSLs) are defined as flat polyps that measure 10 millimeters (mm) or greater. These polyps are known to be easily missed. Per literature review, very few studies have examined gastrointestinal (GI) fellows and the detection rate of LSL’s and patient risk factors for the development of these lesions. In this retrospective study, we collected data on GI fellows performing colonoscopies and investigated the effect of patient BMI, height, weight, age, and gender on LSL detection. Methods: A Retrospective review of 795 patients undergoing colonoscopy at an urban university hospital were analyzed. Demographic data, details of GI fellow and pathology found on colonoscopy were recorded. Continuous variables were summarized using median values and interquartile ranges, and categorical variables were summarized using frequencies and percentages. Multiple linear regression analysis was performed between groups. Results: For our patient population, median age was 58 years, 396 (49.8%) were male, 368 (46.3%) Caucasian, and 386 (48.6%) African American. There were 15 performing fellows, ranging from first year (F1) to third year (F3) of training. Our overall LSL detection rate was 3.2%. Using logistic regression model, we found that age (OR = 1.5044, p = 0.0598) and GI fellow training (OR = 4.4402, p = 0.0495) were significantly associated with LSL detection rate. When age is increased by 10 years, we expect the odds of detecting LSLs to be increased by 50.4%. When compared to F1s, the odds of detecting LSLs is expected to be around 4 times higher for F2s and F3s. Discussion: The LSL detection rate was lower in this single academic training program for F1s compared to F2s and F3s. Based on this study, further research should be conducted on multiple training programs in a prospective fashion to elicit the LSL detection to see if this is a national trend. Further studies investigating a national standard for LSL detection rate would also better help understand our data. Additionally, future studies could also focus on quality improvement targets for LSL’s in GI fellows. Our data did show that an increase in age showed a significant increase in the odds of finding LSLs. Limitations of our study were retrospective analysis and number of GI fellows. Results of our study may have future implications in scheduling patients with certain characteristics that may expose GI fellows to more practice with LSLs.
Disclosures: Mohamed Elmasry indicated no relevant financial relationships. Khushboo Gala indicated no relevant financial relationships. Wenjing Cai indicated no relevant financial relationships. Scott Diamond indicated no relevant financial relationships. Amal Shine indicated no relevant financial relationships. David Liu indicated no relevant financial relationships. Nanlong Liu indicated no relevant financial relationships. Don Ramesh Tholkage indicated no relevant financial relationships. Maiying Kong indicated no relevant financial relationships. Craig McClain indicated no relevant financial relationships. Dipendra Parajuli indicated no relevant financial relationships.