A survey of colonoscopic polypectomy practices among clinical gastroenterologists.
BACKGROUND
Polypectomy techniques vary in clinical practice. The aim of this study was to determine patterns of polypectomy practices in a random sample of gastroenterologists.


METHODS
A total of 300 gastroenterologists were selected randomly from the membership directory of a professional society. They were asked to complete a standardized survey by telephone, electronic mail, or facsimile.


RESULTS
The offices of 285 physicians were contacted successfully. A total of 189 (63%) chose to participate. 152 (80%) of these physicians were in private practice, and 37 (20%) were in academic practice. The mean number of years in practice was 15.5 (range 1-46 years). Forceps techniques (cold or hot) dominated other polypectomy methods for polyps 1 to 3 mm in size ( p < 0.0001), whereas electrosurgical snare resection was dominate for polyps 7 to 9 mm in diameter ( p < 0.0001). No method of polypectomy was significantly more likely to be used for polyps 4 to 6 mm in size. The proportion of physicians who had used dye spraying was 8.5%; detachable snares, 20.1%; clips, 20.1%; and submucosal saline solution injection, 82%. Of those who had used submucosal saline solution injection, 29.7% had no rules for its use, and, in the remainder, there was marked variation regarding the criteria. For polyp stalks greater than 1 cm in diameter, 69% used no method to prevent bleeding. Of those who did use preventive techniques, 76% used epinephrine injection. The electrosurgical current used for polypectomy was pure coagulation in 46%, blend in 46%, and pure-cut in 3%; 4% varied the current.


CONCLUSIONS
At present, polypectomy technique among clinical gastroenterologists is highly variable. Some newer ancillary techniques have had extremely limited use thus far.
Singh
Navjot
N
Division of Gastroenterology, Department of Medicine, Indiana University School of Medicine, 550 University Boulevard, IU Hospital, Indianapolis, IN 46202, USA.
Harrison
Matthew
M
Rex
Douglas K
DK
D003111:Colonic Polyps / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D003625:Data Collection; D004564:Electrocoagulation / Q000379:methods; D004598:Electrosurgery / Q000379:methods; D005762:Gastroenterology; D006801:Humans; D007267:Injections; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012494:Sampling Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D013525:Surgical Instruments; D014481:United States
D012965:Sodium Chloride