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National survey of UK endoscopists showing variation in diathermy practice for colonic polypectomy
  1. Ajay M Verma,
  2. Andrew P Chilton
  1. Department of Gastroenterology, Kettering General Hospital NHS Foundation Trust, Kettering, UK
  1. Correspondence to Dr Ajay M Verma, Department of Gastroenterology, Kettering General Hospital NHS Foundation Trust, Kettering NN16 8UZ, UK; ajay.verma{at}nhs.net

Abstract

Introduction Diathermy practice in colonic polypectomy has a poor evidence base. We surveyed endoscopists across the UK to gain an insight in current diathermy practice.

Methods An eight-question survey was designed to be compact, easy to complete, while still capturing the relevant data. This national survey was circulated by the endoscopy committees of the British Society of Gastroenterology and Association of Coloproctology of Great Britain and Ireland.

Results The survey was open between February and October 2016. Analysis showed: (1) 250/348 (71.8%) completed the full survey, 159 gastroenterologists (63.6%), 36 surgeons (14.4%), 34 gastroenterology trainees (13.6%), 21 others (8.4%); (2) predominant use of coagulation current for small pedunculated polypectomy, high rates of cold snare polypectomy for small sessile polyps (right 43.2% > left 34.4%); (3) a combination of coagulation and cutting current, or Endo Cut, was most popular for larger polypectomy; (4) low use of Endo Cut mode irrespective of size/location of polyp (17.2%–32.0%); (5) 204/250 (81.6%) used reduced current settings for right colon polypectomy; and (6) 208/250 (83.2%) were confident on knowledge and use of diathermy.

Conclusion This national survey exposes a wide variation in practice suggesting that colonoscopists employ diathermy modalities that they are comfortable with. As many complications are as direct result of thermal injury and polypectomy is the most frequent therapeutic intervention, appropriate training and formal guidance is lacking.

  • colonoscopy
  • endoscopic polypectomy
  • colonic adenomas

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Footnotes

  • Contributors AMV and APC designed the survey. AMV analysed the data and wrote the manuscript. APC reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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