Appendix orifice polyps: a study of 691 lesions at a single institution.

PURPOSE: Data on the management of appendix orifice lesions are limited. We present our experience on the management of appendix orifice lesions focusing on the range of size, histology, treatment, and outcomes for polyps at the appendix orifice.

METHODS: Retrospective descriptive study at a tertiary referral center.

PATIENTS: Those having appendix orifice lesion removed and sent for histology between 2000 and 2017.

INTERVENTIONS(S): Polypectomy, surgery.

MAIN OUTCOME MEASURES: Polyp size, shape, histology, treatment.

RESULTS: In total, 691 patients matched our inclusion criteria. Screening was the most common indication for colonoscopy (49.1%). Mean size was 10.1 mm. The most common excision method was cold biopsy forceps (36.3%), followed by hot snare (9.3%), cold snare (8.5%), jumbo cold forceps (6.7%), hot biopsy (6.8%), and endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) (4%). Recurrence was seen in 19/184 (10.3%) patients. Index polyps ≥ 10 mm had a significantly higher risk of recurrence compared to those ≤ 5 mm (odds ratio 3.2 95% CI 1.1-9.2, p = 0.027). None of the patients had complications. Surgery was performed in 45/691 (6.5%). Polyps > 5 mm (41/45) were more likely to require surgery than polyps ≤ 5 mm (4/45 6.67%), p < 0.001.

LIMITATIONS: Retrospective study.

CONCLUSION: Appendix orifice polyps can usually be managed by conventional endoscopic polypectomy methods without the need for ESD.