Reporting their findings in the September issue of the journal, Drs Navjot Singh, Matthew Harrison and Douglas K. Rex from the Indiana University School of Medicine, Indianapolis, Indiana, USA, aimed to determine the patterns of polypectomy practices in a random sample of gastroenterologists.
To do this, they contacted 300 gastroenterologists who were randomly selected from the membership directory of a professional society.
Each contacted gastroenterologist was asked to complete a standardized survey by either telephone, email or fax.
In total, 285 gastroenterologists were successfully contacted, of whom 189 (63%) agreed to participate. Within this group, 152 (80%) were in private practice, while the remaining 37 were physicians in academic practice. Overall, the mean number of years of practice was 15.5 (range 1 to 46 years).
|"At present, polypectomy technique among clinical gastroenterologists is highly variable."|
The researchers found that forceps techniques (hot or cold) were the most frequently used method for polyps 1 to 3 mm in size, while in the case of polyps 7 to 9 mm in size, electrosurgical snare resection was predominant.
With polyps in the range 4 to 6 mm, there was no method of polypectomy that was significantly more likely to be used.
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.
The authors conclude from the results of their survey that, "At present, polypectomy technique among clinical gastroenterologists is highly variable."
They add, "Some newer ancillary techniques have had extremely limited use thus far."