Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Deprtment of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Gut Liver. 2021 Nov 15;15(6):878-886. doi: 10.5009/gnl20166.
BACKGROUND/AIMS: As the number of colonoscopies and polypectomies performed continues to increase in many Asian countries, there is a great demand for surveillance colonoscopy. The aim of this study was to investigate the adherence to postpolypectomy surveillance guidelines among physicians in Asia.
A survey study was performed in seven Asian countries. An email invitation with a link to the survey was sent to participants who were asked to complete the questionnaire consisting of eight clinical scenarios.
Of the 137 doctors invited, 123 (89.8%) provided valid responses. Approximately 50% of the participants adhered to the guidelines regardless of the risk of adenoma, except in the case of tubulovillous adenoma ≥10 mm combined with high-grade dysplasia, in which 35% of the participants adhered to the guidelines. The participants were stratified according to the number of colonoscopies performed: ≥20 colonoscopies per month (high volume group) and <20 colonoscopies per month (low volume group). Higher adherence to the postpolypectomy surveillance guidelines was evident in the high volume group (60%) than in the low volume group (25%). The reasons for nonadherence included concern of missed polyps (59%), the low cost of colonoscopy (26%), concern of incomplete resection (25%), and concern of medical liability (15%).
A discrepancy between clinical practice and surveillance guidelines among physicians in Asia was found. Physicians in the low volume group frequently did not adhere to the guidelines, suggesting a need for continuing education and appropriate control. Concerns regarding the quality of colonoscopy and complete polypectomy were the main reasons for nonadherence.
背景/目的：在许多亚洲国家，结肠镜检查和息肉切除术的数量持续增加，因此对监测性结肠镜检查的需求很大。本研究旨在调查亚洲医生对息肉切除术后监测指南的遵循情况。
在七个亚洲国家进行了一项调查研究。向参与者发送了一封带有调查链接的电子邮件邀请，并要求他们完成由八个临床情景组成的问卷。
在受邀的 137 名医生中，有 123 名（89.8%）提供了有效回复。大约 50%的参与者无论腺瘤风险如何都遵循了指南，除了直径≥10mm 的管状绒毛状腺瘤合并高级别异型增生的情况，只有 35%的参与者遵循了指南。根据结肠镜检查的数量对参与者进行分层：每月≥20 例结肠镜检查（高容量组）和每月<20 例结肠镜检查（低容量组）。高容量组（60%）比低容量组（25%）更遵守息肉切除术后监测指南。不遵守指南的原因包括担心遗漏息肉（59%）、结肠镜检查费用低（26%）、担心不完全切除（25%）和担心医疗责任（15%）。
发现亚洲医生的临床实践与监测指南之间存在差异。低容量组的医生经常不遵守指南，这表明需要继续教育和适当的控制。对结肠镜检查质量和完全息肉切除的担忧是不遵守的主要原因。
