Affiliations 

  • 1 Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 2 Department of Endoscopy, Ulaanbaatar Songdo Hospital, Ulaanbaatar, Mongolia
  • 3 Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
  • 4 Division of Gastroenterology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
  • 5 Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 6 Department of Gastroenterology, University of Medicine 1 Yangon, Yangon, Myanmar
  • 7 Gastroentorology Unit, Department of Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
Gut Liver, 2021 05 15;15(3):391-400.
PMID: 32839364 DOI: 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 scenario-based 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 image-based 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.