Office-based colonoscopy in a family practice.

A total of 112 patients, 64 women and 48 men, underwent 157 in-office colonoscopies with intravenous sedation. A total of 113 polyps were found. Thirty polyps were of the diminutive (less than 0.6 cm) hyperplastic (metaplastic) or nonneoplastic type. Forty-three were of the diminutive adenomatous, or villous, neoplastic type, and 40 were neoplastic but larger than 0.6 cm. Biopsies and polypectomies were done. There were no instances of perforation, hemorrhage, or other major complications. A spectrum of other colorectal pathology was found, the majority of which was treated in the office. Patients were risk stratified for surveillance according to polyp histopathology, with nonneoplastic polyps assigned no risk, and neoplastic polyps assigned high risk status. This study demonstrates that for the most reliable prognostication and risk stratification, all polyps should be removed for histopathological assessment.