Effect of time of day and daily endoscopic workload on outcomes of endoscopic mucosal resection for large sessile colon polyps

Background Endoscopic mucosal resection of large non‐pedunculated colon polyps is challenging. Objective To determine if the time of day or daily endoscopic workload play a role in outcomes of endoscopic mucosal resection for large non‐pedunculated colon polyps greater than 20 mm. Methods This is a retrospective study of patients who underwent endoscopic mucosal resection of large non‐pedunculated colon polyps. The time of day and endoscopic workload were compared across the following outcomes: the rate of complete resection of the polyp, the rate of referral for surgery, and the rate of residual neoplasia on follow‐up. Results One hundred and three endoscopic mucosal resection procedures were performed. There were no differences in the rates of complete resection (80.8% vs. 70.0%; P  = 0.25), the need for surgery (27.4% vs. 33.3%; P  = 0.55), and rate of residual neoplasia (24.5% vs. 50.0%; P  = 0.07) when comparing the time of day. Colon polyps greater than 40 mm were less likely to be completely resected versus polyps sized 20–39 mm (56.8% vs. 91.9%; P  < 0.001). In cases with no residual neoplasia on follow‐up, the mean duration for the index procedure was 45.6 minutes versus 60.7 minutes when there was residual neoplasia ( P  < 0.01). Conclusion The time of day and endoscopic workload does not affect outcomes for endoscopic mucosal resection of large non‐pedunculated colon polyps, but the size of large non‐pedunculated colon polyps and resection times do.