title: British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland guidelines for the management of large non-pedunculated colorectal polyps.
abstract: These guidelines provide an evidence-based framework for the management of patients with large non-pedunculated colorectal polyps (LNPCPs), in addition to identifying key performance indicators (KPIs) that permit the audit of quality outcomes. These are areas not previously covered by British Society of Gastroenterology (BSG) Guidelines.A National Institute of Health and Care Excellence (NICE) compliant BSG guideline development process was used throughout and the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to structure the guideline development process. A systematic review of literature was conducted for English language articles up to May 2014 concerning the assessment and management of LNPCPs. Quality of evaluated studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist System. Proposed recommendation statements were evaluated by each member of the Guideline Development Group (GDG) on a scale from 1 (strongly agree) to 5 (strongly disagree) with >80% agreement required for consensus to be reached. Where consensus was not reached a modified Delphi process was used to re-evaluate and modify proposed statements until consensus was reached or the statement discarded. A round table meeting was subsequently held to finalise recommendations and to evaluate the strength of evidence discussed. The GRADE tool was used to assess the strength of evidence and strength of recommendation for finalised statements.KPIs, a training framework and potential research questions for the management of LNPCPs were also developed. It is hoped that these guidelines will improve the assessment and management of LNPCPs.
authors.affiliation: Department of Gastroenterology, University Hospital of North Tees, Stockton on Tees, UK School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, UK.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Rutter
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, UK.
authors.forename: Amit
authors.initials: A
authors.lastname: Chattree
authors.affiliation: Department of Gastroenterology, Queen Elizabeth Hospital, Gateshead, UK.
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Barbour
authors.affiliation: Wolfson Unit for Endoscopy, St Mark's Hospital, London, UK.
authors.forename: Siwan
authors.initials: S
authors.lastname: Thomas-Gibson
authors.affiliation: Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Bhandari
authors.affiliation: Wolfson Unit for Endoscopy, St Mark's Hospital, London, UK.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Saunders
authors.affiliation: Department of Gastroenterology, New Cross Hospital, Wolverhampton, UK.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Veitch
authors.affiliation: Department of Gastroenterology, Cheltenham General Hospital, Cheltenham, UK.
authors.forename: John
authors.initials: J
authors.lastname: Anderson
authors.affiliation: Department of Gastroenterology, Leeds General Infirmary, Leeds, UK.
authors.forename: Bjorn J
authors.initials: BJ
authors.lastname: Rembacken
authors.affiliation: Department of Histopathology, Royal Victoria Hospital, Belfast, UK.
authors.forename: Maurice B
authors.initials: MB
authors.lastname: Loughrey
authors.affiliation: Department of Colorectal Surgery, Torbay Hospital, Torquay, UK.
authors.forename: Rupert
authors.initials: R
authors.lastname: Pullan
authors.affiliation: Department of Colorectal Surgery, Medway Maritime Hospital, Gillingham, UK.
authors.forename: William V
authors.initials: WV
authors.lastname: Garrett
authors.affiliation: Department of Gastroenterology, University Hospital Llandough, Cardiff, UK.
authors.forename: Gethin
authors.initials: G
authors.lastname: Lewis
authors.affiliation: Department of Gastroenterology, University Hospital Llandough, Cardiff, UK.
authors.forename: Sunil
authors.initials: S
authors.lastname: Dolwani
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage; D003111:Colonic Polyps / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D033183:Interdisciplinary Communication; D007494:Ireland; D010353:Patient Education as Topic; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D019984:Quality Indicators, Health Care; D012002:Rectal Diseases / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D006113:United Kingdom
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
keywords: COLONIC POLYPS; COLORECTAL ADENOMAS; ENDOSCOPIC POLYPECTOMY; ENDOSCOPY; SURGICAL RESECTION