With a special focus on colorectal cancer prevention and detection, the Houston Methodist gastroenterologists who perform colonoscopies are part of the GI Quality Improvement Consortium, a national quality benchmarking registry that monitors colonoscopy performance and outcomes. More than 50 gastroenterologists across seven Houston Methodist locations participate in the registry, giving physicians insight into their outcomes by leveraging nationally established quality measures.

"In place for nearly a decade at Houston Methodist, the Quality Improvement Consortium shows we are performing at the highest possible level for colon polyp detection and cancer prevention," said Dr. Karen L. Woods, a Houston Methodist gastroenterologist.

Collectively, Houston Methodist's adenoma detection rate (ADR) — which is inversely related to cancer development and mortality — has consistently exceeded the national recommended benchmark of 25%. In 2022, the hospital system's ADR was 43.6%, exceeding that of national peer institutions.

"We know that high adenoma detection rates reduce interval colon cancer development," Dr. Woods said. "We are unique in that our large institution is systematically monitoring physician performance to ensure that patients always receive a high-quality colonoscopy. Data shows not all colonoscopies are equal, so our quality is differentiating."

Houston Methodist's interventional GI physicians are experts at removing large, difficult polyps endoscopically, often avoiding the need for surgery. Advanced molecular diagnostics performed by the Pathology Department further aid in treatment planning of colorectal cancers.

Surgeons at Houston Methodist use minimally invasive approaches in more than 95% of colorectal surgeries, resulting in faster recovery, less pain and fewer complications.

Additionally, Houston Methodist physicians developed an advanced technique known as the NICE procedure in 2018. The natural orifice intracorporeal anastomosis with extraction of specimen (NICE) procedure uses robotic technologies that avoid any abdominal wall incisions during colorectal cancer resection.

"We have shown in peer-reviewed publications and at national and international meetings that the NICE procedure affords numerous patient benefits, including avoidance of opioids in recovery and an early return to daily activities," said Dr. Eric Haas, a colorectal surgeon at Houston Methodist. "This and other innovative procedures have helped us achieve significantly shorter postoperative hospital stays and lower surgical site infection and complication rates compared to national averages."

Clinical differentiators

• Pioneered the robotic NICE procedure
• Developed advanced endoscopic techniques to remove large polyps that have historically required surgery
• Home to one of the largest advanced minimally invasive fellowship programs in the country.
• Employ techniques that reduce the need for colostomies, successfully reverse colostomies, and often eliminate the need for opioids

Research initiatives

• Clinical trials and protocols for comprehensive molecular profiling of colorectal tumor tissues to guide immunotherapy and targeted chemotherapy
• Circulating tumor DNA usage for all patients after curative surgeries to evaluate for minimal residual disease and close surveillance and monitoring
• Robotic-assisted technologies and techniques for cancer resection, including national and international presentations on the NICE procedure