Gut Liver.  2025 Jan;19(1):77-86. 10.5009/gnl240217.

Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines

• Kim J
• Gweon TG
• Kwak MS
• Kim SY
• Kim SJ
• Kim HG
• Hong SN
• Kim ES
• Moon CM
• Myung DS
• Baek DH
• Oh SJ
• Lee HJ
• Lee JY
• Jung Y
• Chun J
• Yang DH
• Kim ER
• ITRGotKAftSoID

• KMID: 2564736
• DOI: http://doi.org/10.5009/gnl240217

Abstract

Background/Aims
We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps.
Methods
From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines.
Results
Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experience in colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions.
Conclusions
Adherence to the guidelines for endoscopic resection techniques varied depend- ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Keyword

Colonic polyps; Endoscopic mucosal resection; Endoscopic submucosal dissection; Polypectomy