Outcomes of large colorectal polyp endoscopic resections during small audience live endoscopy events with endoscopist at their home endoscopy unit

Background and study aims Live endoscopy courses are popular. The safety of performing live endoscopy has been questioned. In this study, we compared outcomes of large colorectal polyp resections during live endoscopy events (LEEs) (with a small audience of 2 to 5 physicians) to those removed during standard procedure days (SPDs) (without an audience). All procedures were performed at the endoscopist's home unit. Methods Retrospective assessment of the adverse event (AE) and recurrence rates for large (>= 20 mm) non-pedunculated colorectal lesions removed during LEEs. Logistic regression was used to assess whether presence of an audience predicted worse outcomes. Results From January 2017 to May 2021, 317 lesions were removed with a live audience and 866 were removed on SPDs. Polyp pathology and procedure length were similar in both groups. There were 16 (5.0%) total adverse events in the LEE group and 30 (3.4%) in the SPD group (P= 0.224). The majority in both groups were delayed hemorrhage. There were 2 (0.6%) perforations in the LEE and 3 (0.3%) in the SPD group. Increasing polyp size was associated with more AEs and higher recurrence. Increasing patient age predicted higher recurrence, and thermal injury of the resection margin predicted lower recurrence. There were no other predictors of AEs or recurrence, including presence of a live audience. Conclusions Removing large colorectal polyps with a small live audience did not increase adverse outcomes.