Colonoscopic polypectomy preferences among gastrointestinal endoscopists in the Philippines: Results of an online survey-based cross sectional study
Keywords:
colon, rectum, polyp, colonoscopy, polypectomy, surveyAbstract
Significance: To date, no study has investigated colonoscopic polypectomy preferences among endoscopists in the Philippines. This study aimed to assess current knowledge and practices of endoscopists on polypectomy and to determine the factors associated with adherence to recent polypectomy guidelines, particularly on cold snare polypectomy for small polyps. These results may streamline training programs to improve the utility of colonoscopy in preventing colorectal cancer (CRC).
Methodology: Endoscopists and trainees were recruited by convenience sampling to an online survey determining preferences in polypectomy techniques for different scenarios of polyps. Descriptive statistics, univariate analysis and logistic regression were used for statistical analysis.
Results: 105 responses were included in the final analysis. For sessile polyps, cold forceps polypectomy was preferred for 1-3 mm polyps (74%). Cold snare polypectomy (CSP) was preferred for lesions 4-5 mm (39%). CSP and hot snare polypectomy (HSP) were equally favored for lesions 6-9 mm (34%). Endoscopic mucosal resection (EMR) was preferred for benign lesions >10 mm (38%), but most preferred to refer to an expert endoscopist for suspicious malignant lesions (53%). HSP was preferred for pedunculated polyps (75-80%). On univariate analysis and logistic regression, attendance to workshops on image-enhanced endoscopy (IEE) (p = 0.025), location of practice (p < 0.001), endoscopist’s confidence in using IEE (p = 0.013) and adhering to guidelines (p = 0.007), and number of colonoscopies performed in a year (p = 0.033) were associated with using CSP on sessile polyps <10mm.
Conclusion: Holding more workshops on polypectomy and IEE–targeted especially to endoscopists in areas other than the National Capital Region (NCR) and those who perform fewer colonoscopies–may improve adherence to the most recent polypectomy guidelines.
