Factors* | N (%) | Group |
---|---|---|
I am happy to leave large EMRs for my colleagues to tackle | 74 (27.6%) | G,J |
Lesions that I don't tackle are better dealt with surgically | 69 (25.7%) | G,S,J |
A more experienced endoscopist is available in my unit | 68 (25.4%) | G,J |
Large rectal lesions are better dealt with by TEMS | 66 (24.6%) | G,S,J |
I feel I operate close to the limit of what is technically possible by EMR | 66 (24.6%) | J |
Lack of time/list space to undertake large EMRs | 51 (19.0%) | R |
Lack of formal training in EMR | 49 (18.3%) | T |
Lack of opportunity to gain experience in EMR | 48 (17.9%) | T |
A more experienced endoscopist is available in my region | 46 (17.2%) | G |
Lack of guidelines for management of patients with large polyps | 20 (7.5%) | R |
Lack of financial reimbursement for advanced polypectomy | 16 (6.0%) | R |
Large colonic lesions are better dealt with using laparoscopic assistance | 12 (4.5%) | S,J |
Lack of support from managers, endoscopy nursing staff or colleagues | 9 (3.4%) | R |
Total number of responses | 594 |
Responders reported that their advanced polypectomy practice was limited due to the availability of more experienced colleagues, surgical technical superiority and a lack of formal training. Less common reasons included a lack of guidelines for EMR, a lack of financial reimbursement or support from their institution or colleagues.
*Multiple responses possible.
EMR, endoscopic mucosal resection; G, governance; J, judgment; R, resource; S, surgical; T, training.