Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. May 16, 2023; 15(5): 338-353
Published online May 16, 2023. doi: 10.4253/wjge.v15.i5.338
Unlocking quality in endoscopic mucosal resection
Eoin Keating, Jan Leyden, Donal B O'Connor, Conor Lahiff
Eoin Keating, Jan Leyden, Conor Lahiff, Department of Gastroenterology, Mater Misericordiae University Hospital, Dublin 7, Ireland
Eoin Keating, Jan Leyden, Conor Lahiff, School of Medicine, University College Dublin, Dublin 4, Ireland
Donal B O'Connor, Department of Surgery, Tallaght University Hospital, Dublin 24, Ireland
Donal B O'Connor, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
Author contributions: Keating E designed and drafted the original manuscript and reviewed all subsequent and final drafts; Leyden J and O’Connor D reviewed the draft and final manuscripts; Lahiff C designed and reviewed the original manuscript; all subsequent drafts, including the final draft.
Conflict-of-interest statement: The authors declare no conflict of interests for this review article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Eoin Keating, MBChB, MRCPI, Doctor, Department of Gastroenterology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.
Received: December 28, 2022
Peer-review started: December 28, 2022
First decision: February 8, 2023
Revised: February 24, 2023
Accepted: April 12, 2023
Article in press: April 12, 2023
Published online: May 16, 2023

A review of the development of the key performance metrics of endoscopic mucosal resection (EMR), learning from the experience of the establishment of widespread colonoscopy quality measurements. Potential future performance markers for both colonoscopy and EMR are also evaluated to ensure continued high quality performance is maintained with a focus service framework and predictors of patient outcome.

Keywords: Endoscopic mucosal resection, Colonoscopy, Quality in endoscopy, Advanced therapeutic endoscopy, Large non pedunculated colorectal polyps, Key performance indicators

Core Tip: Colonoscopy quality and key performance indicators (KPIs) are a mainstay of endoscopy practice. Adherence to colonoscopy KPIs is important for trainees and consultant endoscopists and is closely linked to patient outcomes. High quality colonoscopy often yields complex polyps, the management of which is now primarily endoscopic. Endoscopic resection of complex polyps thus requires similar scrutiny to diagnostic colonoscopy, to ensure consistent standards are applied. In this review, we discuss existing colonoscopy quality indicators, evaluate some potential new markers and the evidence base for KPIs in the management of complex polyps.