Gut Liver.
2021 May;15(3):391-400. 10.5009/gnl20140.
Colonoscopic Polypectomy Preferences of Asian Endoscopists: Results of a Survey-Based Study
- Affiliations
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- 1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 2Department of Endoscopy, Ulaanbaatar Songdo Hospital, Ulaanbaatar, Mongolia.
- 3Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- 4Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
- 5Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
- 6Division of Gastroenterology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
- 7Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- 8Department of Gastroenterology, University of Medicine 1 Yangon, Yangon, Myanmar.
- 9Gastroentorology Unit, Department of Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
- KMID: 2515843
- DOI: http://doi.org/10.5009/gnl20140
Abstract
- Background/Aims
The clinical practice pattern of polypectomy is not well-investigated in Asian countries. We aimed to survey Asian endoscopists about their preferred polypectomy techniques for given conditions and images of polyps.
Methods
A survey was performed using questionnaires composed of two parts: a scenariobased questionnaire using scenarios of polyps, which were adopted from the European Society of Gastrointestinal Endoscopy guidelines, and an image-based questionnaire using provided endoscopic images of polyps.
Results
A total of 154 endoscopists participated in this survey. The most preferred resection techniques for diminutive (≤5 mm), small (6–9 mm), and benign-looking intermediate (10–19 mm) nonpedunculated polyps were cold forceps polypectomy, hot snare polypectomy, and endoscop-ic mucosal resection (EMR), respectively, in both the scenario- and image-based questionnaires. For benign-looking large (≥20 mm) nonpedunculated polyps, EMR and endoscopic submucosal dissection (ESD) were preferred in the scenario- and image-based surveys, respectively. In case of malignant nonpedunculated polyps, EMR and ESD were preferred for intermediate-sized and large lesions, respectively, according to the scenario-based survey. However, ESD was preferred in both intermediate-sized and large malignant nonpedunculated polyps according to the imagebased survey. Trainee endoscopists, endoscopists working in referral centers, and endoscopists in the colorectal cancer–prevalent countries were independently associated with preference of cold snare polypectomy for removing small polyps.
Conclusions
The polypectomy practice patterns of Asian endoscopists vary, and cold snare polypectomy was not the most preferred resection method for polyps <10 mm in size, in contrast to recent guidelines.
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