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Title: The current practice standard for colonoscopy in Australia.
Austin Authors: Chandran, Sujievvan ;Parker, Frank;Vaughan, Rhys B ;Efthymiou, Marios 
Affiliation: Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia
Department of Anesthetics, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 12-Dec-2013
Publication information: Gastrointestinal Endoscopy 2013; 79(3): 473-9
Abstract: Despite having one of the highest rates per capita for colonoscopy worldwide, colorectal cancer remains the second most commonly diagnosed malignancy in Australia.Our aim was to document colonoscopy/polypectomy practice nationwide and assess whether significant differences exist.Observational study.Online survey conducted nationally in 2012.Medical practitioners registered with the Gastroenterological Society of Australia practicing colonoscopy.Rates of polypectomy techniques for varying polyp sizes, postpolypectomy bleeding prophylaxis techniques, and adenoma detection practices. To assess whether variations exist according to practice location, specialty, and experience and comparison of practice with a previous American cohort.Of the 846 members contacted, 244 (28.8%) responded. The cohort consisted primarily of consultant gastroenterologists (182/244, 74.6%). The cold-snare technique was preferred (165/244, 67.6%) for polyps 3 mm in size; however, this decreased rapidly with increasing polyp size (5 mm [120/244, 49.2%] and 7-9 mm [18/244, 7.4%]). EMR was the preferred method of resection for polyps 7 to 9 mm in size (148/244, 60.7%). The withdrawal technique predominantly consisted of double-passing high-risk areas and rectal retroflexion (134/244, 54.9%). Significant differences across specialty, location, and experience included polypectomy method for diminutive polyps, the use of EMR, and retroflexion.Survey-based study and response rate.Although variations in colonoscopy and polypectomy practice exist, the majority of our cohort performs cold-snare polypectomy for diminutive polyps and pass high-risk, poorly visualized areas twice on withdrawal. This is a significant shift in practice from that of the U.S. cohort studied 10 years earlier.
DOI: 10.1016/j.gie.2013.10.050
Type: Journal Article
Blood Loss, Surgical.prevention & control
Clinical Competence
Colonoscopy.methods.statistics & numerical data
Gastroenterology.methods.statistics & numerical data
Health Care Surveys
Narrow Band Imaging.utilization
Professional Practice Location
Referral and Consultation.statistics & numerical data
United States
Appears in Collections:Journal articles

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