Frequency of Errors in Colorectal Lesion Description and Management Prior to Referral to A Tertiary Center.

Background and aims: Accurate reporting of polyp characteristics is crucial for effective resource allocation in endoscopic resection referrals. We present our experience with pre-referral management of challenging colorectal lesions.

Methods: We reviewed a prospectively collected database of consecutive referrals for endoscopic resection of challenging colorectal lesions. The database included details of prior colonoscopies. We assessed pre-referral management using established guidelines.

Results: Among 1,826 referred lesions in 1826 patients, size estimates were missing for 421 (24%) lesions; 56 (3.2%) were found twice as large as previously estimated, while 65 (3.7%) were half the previous estimate. Morphological descriptions were absent for 376 (22%) polyps. Tattooing was performed for 822 (47%) lesions, with 247 (30%) placed correctly. Of the 1,103 (77%) polyps biopsied, only 11 (1.1%) were classified as high-risk by the referring endoscopist.

Conclusions: Errors in pre-referral management of challenging colorectal lesions are frequent. Improved adherence to national guidelines could enhance practice.