A survey of colonoscopic polypectomy practices among clinical gastroenterologists
A survey of colonoscopic polypectomy practices among clinical gastroenterologists
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DOI：
10.1016/s0016-5107(04)01808-5
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发表时间：
2004-09-01
影响因子：
7.7
通讯作者：
Rex, DK
中科院分区：
文献类型：
--
作者：
Singh, N;Harrison, M;Rex, DK
背景：息肉切除术技术在临床实践中有所不同。本研究的目的是在随机抽样的胃肠病学家中确定息肉切除术的模式。方法：从某专业学会会员名录中随机抽取300名胃肠病学家。他们被要求通过电话、电子邮件或传真完成一项标准化调查。结果：成功联系285名医师。共有189人（63%）选择参加。这些医生中有152人（80%）从事私人执业，37人（20%）从事学术执业。平均执业年数为15.5年（范围1 - 46年）。对于直径为1 - 3mm的息肉，钳技术（冷或热）在其他息肉切除术中占主导地位（p < 0.0001），而对于直径为7 - 9mm的息肉，电手术圈套切除术占主导地位（p < 0.0001）。没有任何一种方法更可能用于4至6mm大小的息肉。使用过染色喷雾的医师比例为8.5%；可拆卸陷阱，20.1%；剪辑,20.1%;粘膜下生理盐水注射，82%。在使用粘膜下盐水溶液注射的患者中，29.7%的患者没有使用规则，其余患者的使用标准有明显差异。对于息肉柄直径大于1cm的患者，69%的患者没有使用任何止血方法。在那些使用预防技术的人中，76%的人使用肾上腺素注射。用于息肉切除术的电切电流为纯凝固46%，混合46%，纯切割3%；4%改变了电流。结论：目前，临床胃肠病学家的息肉切除术技术差异很大。到目前为止，一些较新的辅助技术的使用极为有限。
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.