Document Type


Original Publication Date


Journal/Book/Conference Title

Journal of Surgical Oncology





First Page


Last Page


DOI of Original Publication



Published in final form at doi: 10.1002/jso.23615.

Date of Submission

May 2015


Background: A use of polypectomy techniques by endoscopist specialty (primary care, surgery, and gastroenterology) and experience (volume), and associations with serious gastrointestinal adverse events, were examined.

Methods: A retrospective follow-up study with ambulatory surgery and hospital discharge datasets from Florida, 1999-2001, was used. Thirty-day hospitalizations due to colonic perforations and gastrointestinal bleeding were investigated for 323,585 patients.

Results: Primary care endoscopists and surgeons used hot biopsy forceps/ablation, while gastroenterologists provided snare polypectomy or complex colonoscopy. Low-volume endoscopists were more likely to use simpler rather than complex procedures. For hot forceps/ablation and snare polypectomy, low- and medium-volume endoscopists reported higher odds of adverse events. For complex colonoscopy, higher odds of adverse events were reported for primary care endoscopists (1.74 [95%CI, 1.18 to 2.56]) relative to gastroenterologists

Conclusions: Endoscopists regardless of specialty and experience can safely use cold biopsy forceps. For hot biopsy and snare polypectomy, low volume, but not specialty, contributed to increased odds of adverse events. For complex colonoscopy, primary care specialty, but not low volume, added to the odds of adverse events. Comparable outcomes were reported for surgeons and gastroenterologists. Cross-training and continuing medical education of primary care endoscopists in high-volume endoscopy settings are recommended for complex colonoscopy procedures.


© 2014 Wiley Periodicals, Inc. This is the peer reviewed version of the following article: Chukmaitov, A., Bradley, C. J., Dahman, B., Siangphoe, U., BouHaidar, D. and Warren, J. L. (2014), Polypectomy techniques, endoscopist characteristics, and serious gastrointestinal adverse events. J. Surg. Oncol., 110: 207–213, which has been published in final form at doi: 10.1002/jso.23615. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

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VCU Healthcare Policy and Research Publications