Colonoscopic Polypectomy Preferences of Asian Endoscopists: Results of a Survey-Based Study

• Published in: Gut and liver Vol. 15; no. 3; pp. 391 - 400
• Main Authors: Dong-hoon Yang, Bayasgalan Luvsandagva, Quang Trung Tran, Achmad Fauzi, Panida Piyachaturawat, Thida Soe, Zhiqin Wong, Jeong-sik Byeon
• Format: Journal Article
• Language: Korean
• Published: 대한소화기기능성질환·운동학회 30.05.2021
• Subjects: Colon; Polyp; Polypectomy; Rectum; Survey
• ISSN: 1976-2283

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 endoscopic 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. (Gut Liver 2021;15:391-400)