Copyright
©The Author(s) 2022.
World J Gastrointest Endosc. Apr 16, 2022; 14(4): 235-249
Published online Apr 16, 2022. doi: 10.4253/wjge.v14.i4.235
Published online Apr 16, 2022. doi: 10.4253/wjge.v14.i4.235
Table 1 Demographic characteristics of the surveyed physicians
Variable | Frequency (n = 833) | Percent (%) |
Gender | ||
Male | 560 | 67.2 |
Female | 273 | 32.8 |
Age (yr) | ||
≤ 35 | 276 | 33.1 |
36-45 | 366 | 43.9 |
> 45 | 191 | 22.9 |
Academic categories | ||
Consultants | 464 | 55.7 |
Residents | 36 | 4.3 |
Specialist | 333 | 40.0 |
Career specialty | ||
Gastroenterologist | 678 | 81.4 |
General medicine | 121 | 14.5 |
Surgery | 34 | 4.1 |
Years of practice (yr) | ||
< 5 | 145 | 17.4 |
5-10 | 120 | 14.4 |
10-15 | 200 | 24.0 |
> 15 | 368 | 44.2 |
Main hospital of practice | ||
Central | 80 | 9.6 |
General | 111 | 13.3 |
Teaching institution | 73 | 8.8 |
University | 569 | 68.3 |
Table 2 Assessment of knowledge among the surveyed physicians
Variable | Number | Percent |
What is superficial bowel neoplasia? | ||
True | 736 | 88.4 |
False | 97 | 11.6 |
Superficial bowel neoplasia can be diagnosed with? | ||
True | 547 | 65.7 |
False | 286 | 34.3 |
What is the best option for the treatment of bowel cancer in general? | ||
True | 473 | 56.8 |
False | 360 | 43.2 |
What is the best treatment for superficial bowel neoplasia? | ||
True | 526 | 63.1 |
False | 307 | 36.9 |
What does polypectomy mean? | ||
True | 767 | 92.1 |
False | 66 | 7.9 |
What does EMR stand for? | ||
True | 751 | 90.2 |
False | 82 | 9.8 |
What does ESD stand for? | ||
True | 742 | 89.1 |
FalseE | 91 | 10.9 |
The best endoscopic treatment option for pedunculated polyps | ||
True | 609 | 73.1 |
False | 224 | 26.9 |
The best endoscopic treatment option for non-pedunculated lesions ≤ 15 mm in diameter | ||
True | 473 | 56.8 |
False | 360 | 43.2 |
The best endoscopic treatment option for non-pedunculated lesions ≥ 20 mm | ||
True | 421 | 50.5 |
False | 412 | 49.5 |
Endoscopic resection is a suitable treatment? | ||
True | 596 | 71.5 |
False | 237 | 28.5 |
Table 3 Attitude of the surveyed physicians towards superficial bowel neoplasia
Question (%) | Frequency | Percent |
How frequently do you refer your patients for endoscopic screening of superficial bowel cancer in high-risk groups? (% of the high-risk patients you see) | ||
0 | 102 | 12.2 |
25 | 386 | 46.3 |
50 | 116 | 13.9 |
75 | 103 | 12.4 |
100 | 126 | 15.1 |
How convinced you are with endoscopic treatment of superficial bowel cancer? | ||
Convinced | 567 | 68.1 |
I don't Know | 175 | 21 |
Not convinced at all | 91 | 10.9 |
How frequently do you refer a patient with endoscopic features of superficial bowel cancer for endoscopic resection? (% of the patients you see) | ||
0 | 235 | 28.2 |
25 | 301 | 36.1 |
50 | 115 | 13.8 |
75 | 108 | 13 |
100 | 74 | 8.9 |
How frequently do you refer a patient with endoscopic features of superficial bowel cancer for surgical management? (% of the patients you see) | ||
0 | 147 | 17.6 |
25 | 290 | 34.8 |
50 | 212 | 25.5 |
75 | 64 | 7.7 |
100 | 120 | 14.4 |
In your institution do you have a panel to discuss the treatment options for superficial bowel neoplasia? | ||
No | 518 | 62.2 |
Yes | 315 | 37.8 |
Table 4 Basic endoscopic practice knowledge for endoscopic resection techniques among the surveyed endoscopists
Question | Number (N = 570) | Percentage (%) |
Are you trained formally on endoscopic polypectomy? | ||
No | 134 | 23.5 |
Yes | 436 | 76.5 |
Are you trained formally on EMR? | ||
No | 388 | 68.1 |
Yes | 182 | 31.9 |
Are you trained formally on ESD? | ||
No | 528 | 92.6 |
Yes | 42 | 7.4 |
Do you use Paris classification in reporting the lesions? | ||
No | 239 | 41.9 |
Yes | 331 | 58.1 |
Do you use Kudo classification in reporting the lesions? | ||
No | 371 | 65.1 |
Yes | 199 | 34.9 |
Do you use classifications other than Paris and Kudo in reporting the lesions? | ||
No | 510 | 89.5 |
Yes | 60 | 10.5 |
Which of the following practices increase sub-mucosal fibrosis and hence affect the success of advanced endoscopic resection techniques | ||
All apply | 363 | 63.7 |
Extensive biopsies | 117 | 20.5 |
Partial snare polypectomy | 24 | 4.2 |
Tattoo injection for marking immediately under or close by a lesion | 66 | 11.6 |
Table 5 Individual competency in endoscopic resection techniques among the surveyed endoscopists
Question | Number (N = 570) | Percentage (%) |
How many polyps did you excised in the last year? | ||
0 | 384 | 67.4 |
11-20 | 96 | 16.8 |
21-30 | 30 | 5.3 |
41-50 | 36 | 6.3 |
Less than 10 | 12 | 2.1 |
More than 50 | 12 | 2.1 |
How many EMRs did you perform in the last year? | ||
0 | 408 | 71.6 |
10-20 | 48 | 8.4 |
20-30 | 12 | 2.1 |
Less than 10 | 102 | 17.9 |
How many ESDs did you perform in the last year? | ||
0 | 504 | 88.4 |
10-20 | 12 | 2.1 |
Less than 10 | 54 | 9.5 |
How many complications from endoscopic resection techniques have you had in the last year (% of your total cases)? | ||
0 | 329 | 57.7 |
0.25 | 91 | 16.0 |
0.5 | 12 | 2.1 |
I don't practice advanced endoscopic techniques | 138 | 24.2 |
How competent are you in managing the complications of endoscopic resection techniques? | ||
Competent | 147 | 25.8 |
I am not sure | 284 | 49.8 |
Non-competent | 139 | 24.4 |
Table 6 Parameters of the endoscopy units’ infrastructures among the surveyed endoscopists
% | Number (n = 570) | Percent |
How many independent endoscopists are in your unit? | ||
Less than 5 | 170 | 29.8 |
5-10 | 164 | 28.8 |
More than 10 | 236 | 41.4 |
The nursing staff in your endoscopy unit are knowledgeable and trained on endoscopic resection techniques | ||
No | 297 | 52.1 |
Yes | 273 | 47.9 |
How sufficient is the number of endoscopes in your unit to perform all endoscopy duties? | ||
I am not sure | 36 | 6.3 |
Not- Sufficient | 310 | 54.4 |
Sufficient | 224 | 39.3 |
How many endoscopes with optical enhancement (NBI- i-SCAN- FICE) are available in your unit (% of the total scopes in your unit) | ||
0.00 | 135 | 23.7 |
25.00 | 242 | 42.5 |
50.00 | 126 | 22.1 |
75.00 | 43 | 7.5 |
100.00 | 24 | 4.2 |
Dyes for chromoendoscopy are available in your unit | ||
No | 455 | 79.8 |
Yes | 115 | 20.2 |
Advanced Diathermy unit with different endoscopy modes is available in your unit | ||
No | 181 | 31.8 |
Yes | 389 | 68.2 |
APC is available in your unit | ||
No | 61 | 10.7 |
Yes | 509 | 89.3 |
Haemoclips are available in your unit | ||
No | 79 | 13.9 |
Yes | 491 | 86.1 |
In your endoscopy unit, the endoscopic resection techniques are operated under anesthesiologist’s observation | ||
No | 110 | 19.3 |
Yes | 460 | 80.7 |
The most commonly reported complications from endoscopic resection techniques in your unit | ||
Delayed bleeding | 24 | 4.2 |
Perforations, | 97 | 17.0 |
Procedural bleeding | 152 | 26.7 |
Sedation or anesthesia-related | 12 | 2.1 |
We do not perform advanced endoscopic resection | 285 | 50.0 |
Your institution is ready for managing the complications of endoscopic resection techniques? | ||
I am not sure | 218 | 38.2 |
No | 42 | 7.4 |
Yes | 310 | 54.4 |
The surgical backup team is usually ready to manage complications of your cases | ||
No | 157 | 27.5 |
Yes | 413 | 72.5 |
How many complicated cases following endoscopic resection treated under surgical repair in the last one year within your institution (% from complicated cases) | ||
0.00 | 430 | 75.4 |
25.00 | 74 | 13.0 |
50.00 | 30 | 5.3 |
- Citation: Emara MH, Zaghloul M, Ramadan HKA, Mohamed SY, Tag-Adeen M, Alzamzamy A, Alboraie M, Madkour A, Altonbary AY, Zaher TI, Elhassan AA, Abdeen N, Ahmed MH. Endoscopic resection of superficial bowel neoplasia: The unmet needs in the Egyptian practice. World J Gastrointest Endosc 2022; 14(4): 235-249
- URL: https://www.wjgnet.com/1948-5190/full/v14/i4/235.htm
- DOI: https://dx.doi.org/10.4253/wjge.v14.i4.235