CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(07): E812-E820
DOI: 10.1055/a-0607-0727
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Polypectomy techniques among gastroenterologists in Norway – a nationwide survey

Ina B. Pedersen
1  Department of Medicine, Sørlandet Hospital Kristiansand, Kristiansand, Norway
2  Institute of Health and Society, Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway
,
Magnus Løberg
2  Institute of Health and Society, Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway
3  Department of Transplantation Medicine and K. G. Jebsen Colorectal Cancer Research Center, Oslo University Hospital, Oslo, Norway
,
Geir Hoff
2  Institute of Health and Society, Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway
3  Department of Transplantation Medicine and K. G. Jebsen Colorectal Cancer Research Center, Oslo University Hospital, Oslo, Norway
4  Department of research, Telemark Hospital, Skien, Norway
5  Cancer Registry of Norway, Oslo, Norway
,
Mette Kalager
2  Institute of Health and Society, Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway
3  Department of Transplantation Medicine and K. G. Jebsen Colorectal Cancer Research Center, Oslo University Hospital, Oslo, Norway
,
Michael Bretthauer
2  Institute of Health and Society, Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway
3  Department of Transplantation Medicine and K. G. Jebsen Colorectal Cancer Research Center, Oslo University Hospital, Oslo, Norway
6  Frontier Science, Boston, Massachusetts, United States
,
Øyvind Holme
1  Department of Medicine, Sørlandet Hospital Kristiansand, Kristiansand, Norway
2  Institute of Health and Society, Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway
› Author Affiliations
Further Information

Publication History

submitted 14 December 2017

accepted after revision 19 March 2018

Publication Date:
04 July 2018 (online)

Abstract

Background and study aims Incomplete polyp removal has been estimated to cause 27 % of all colorectal cancers detected soon after colonoscopy. There is limited information regarding polypectomy techniques among endoscopists. The article is a nationwide survey of polypectomy techniques among Norwegian endoscopists.

Materials and methods We invited all board-certified gastroenterologists in Norway to complete a web-based questionnaire about their polypectomy technique. Inadequate polypectomy techniques were defined as using biopsy forceps for polyps larger than 3 mm in diameter, using hot biopsy forceps for polypectomy, and using the same electrocautery output irrespective of polyp size and morphology.

Results Twenty-six of 30 Norwegian gastroenterology departments participated in the study. A total of 119 endoscopists received the survey, and 70 (59 %) responded. Mean duration of endoscopy practice was 11.5 years, and 95 % had performed more than 1,000 colonoscopies during their career. Twenty-eight endoscopists (40 %) used one or more inadequate polypectomy techniques: 10 (14.3 %) used biopsy forceps for removal of polyps larger than 3 mm in diameter, five (7.1 %) used hot biopsy for polypectomy, and 17 (24 %) used the same electrocautery output for all polypectomies. Five (7 %) endoscopists reported that they did not remove polyps smaller than 4 mm.

Conclusion A substantial number of Norwegian endoscopists use inadequate polypectomy techniques. Improved training and certification of endoscopists is warranted.