SMSA polyp grading

  Colonoscopy, Endoscopy

The SMSA (Size, Morphology, Site, Access) polyp grading tool is used as a predictor of the complexity of endoscopic resection.


Related articles:
*Hiroshima classification
*Haggitt level
*Kikuchi
*KUDO pit pattern
*Paris
*SANO classification
*Sydney classification for Deep Mural Injury


Table 1. SMSA scoring system.

BenchmarksPoints
Size<1 cm1
1–1.9 cm3
2–2.9 cm5
3–3.9 cm7
>4 cm9
MorphologyPedunculated1
Sessile2
Flat3
SiteLeft1
Right2
AccessEasy1
Difficult3

Level 1: 4–5 points. Level 2: 6–9 points. Level 3: 10–12 points. Level 4: >12 points.

endoscopic complications rate based on SMSA grading

References:

Sansone S, Ragunath K, Bianco MA, et al. Clinical utility of the SMSA grading tool for the management of colonic neoplastic lesions. Dig Liver Dis. 2017;49(5):518‐522. doi:10.1016/j.dld.2016.12.030