Intest Res.
2011 Dec;9(3):196-205. 10.5217/ir.2011.9.3.196.
A Korean National Survey for Treatment Modality in Colon Polypectomy
- Affiliations
-
- 1Department of Internal Medicine, Ajou University School of Medicine, Korea.
- 2Department of Internal Medicine, Soonchunhyang University College of Medicine, Korea.
- 3Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea. diksmc.park@samsung.com
- 4Department of Internal Medicine, Konkuk University School of Medicine, Korea.
- 5Department of Internal Medicine, Ewha Womans University College of Medicine, Korea.
- 6Department of Internal Medicine, Ulsan University College of Medicine, Korea.
- 7Department of Internal Medicine, Yonsei University College of Medicine, Korea.
- 8Department of Internal Medicine, The Catholic University of Korea College of Medicine, Korea.
- 9Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Korea.
- 10Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
- 11Department of Internal Medicine, Kyung Hee University School of Medicine, Korea.
- 12Department of Radiology, Seoul National University College of Medicine, Korea.
- KMID: 2284947
- DOI: http://doi.org/10.5217/ir.2011.9.3.196
Abstract
- BACKGROUND/AIMS
There are no evidence-based, procedural guidelines to appropriately perform a colon polypectomy. Thus, we investigated the treatment modality for colon polypectomy in Korea, using a web-based e-mail survey.
METHODS
A questionnaire of preferred treatment modality for colon polypectomy was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians who performed colonoscopies as a screening or surveillance program nationwide. Among 425 colonoscopists who were sent the e-mail, 263 replied. We analysed data from 252 colonoscopists who had performed colon polypectomies.
RESULTS
The stopping time for antiplatelet and anticoagulation therapy before a colon polypectomy had a tendency to increase and the restarting time for these drugs was delayed as polyp size increased. Colonoscopists preferred cold biopsy removal for polyps <5 mm in size and a hot snare polypectomy after injecting normal saline and epinephrine mixture for polyps > or =5 mm in size. More than half of colonoscopists preferred observation rather than additional procedures for adenomas with incomplete resection. In contrast, most colonoscopists recommended additional procedures, such as endoscopic mucosal resection, endoscopic submucosal dissection or surgery for an advanced adenoma with incomplete resection. The most preferred prophylactic treatment for immediate postpolypectomy bleeding was hemoclipping.
CONCLUSIONS
Various treatment modalities were used for a colon polypectomy because there are few guidelines for performing a colon polypectomy based on a critical review of the available data. Further well-designed, prospective studies are needed to develop evidence-based guidelines for colon polypectomy.
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