TU2.1 Colonoscopic Polyp Tattooing: To Tattoo or Not to Tattoo?

Abstract Aims Colorectal cancer is often investigated with colonoscopy, where tattooing is performed to identify the location of potentially tumorous polyps to aid surgery and colonic surveillance. BSG guidelines state that polyps ≥20mm in size should be tattooed, except those in the rectum/caecum. Tattoos should be recorded and local policy should be in place. At our trust, St Mark's protocol is used which advises all suspicious lesions be tattooed except those in the rectum/caecum, and 3 tattoos be placed circumferentially. Here, we audit adherence to these guidelines. Methods Retrospective analysis of data collected from Endobase for endoscopies revealing polyps during 2020 at DGH. Results 325 polyps were found in 255 patients (70% male). Sessile and pedunculated polyps were most common, accounting for 77%. Smaller polyps (15–19mm) were most prevalent (52%). Tattooing of smaller polyps (15–19mm) remains low (30%), whereas tattooing of larger polyps has improved (85%). Tattooing of rectal/caecal polyps remains prevalent (19%). Only 30% of tattooed polyps had 3 tattoos. Tattoo information was recorded well in certain sections of Endobase (83% in ‘conclusion’) but poorly in others (61% in ‘therapeutic’). Conclusions There has been an increase in male predominance, and in smaller and pedunculated polyps. These demographic changes are useful to be aware of. Teaching and clearer display of guidelines is required to improve tattooing of smaller polyps, and reduce tattooing of rectal/caecal polyps. However, clearer trust guidelines should accommodate operative variability. Recording tattoo information in Endobase is technically challenging and requires improvement to avoid loss of data.