A Survey on the Management and Surveillance of Low-Grade Gastric Adenoma Among Gastroenterologists in South Korea

Abstract

Low-grade gastric adenomas (LGA) are managed using a variety of methods, unlike high-grade adenomas or early gastric cancers, which follow more standardized treatment protocols. This study aimed to assess the current practices and follow-up strategies used by South Korean gastroenterologists in managing LGA. An online survey was created with Google Forms and distributed to South Korean gastroenterologists via email or paper instructions containing a Quick Response code. A total of 130 South Korean gastroenterologists responded to the survey. The size criteria for endoscopic treatment of LGAs were as follows: size-independent (68.5%), ≥5 mm (13.1%), ≥1 cm (16.2%), ≥1.5 cm (0.8%), and ≥2 cm (1.5%). Treatment decisions, such as performing endoscopic submucosal dissection, were primarily influenced by lesion size (88.5%), endoscopic appearance (62.3%), and location (41.5%). For lesions ≥1.5 cm, 85.3% (n=111) of respondents favored endoscopic submucosal dissection, whereas for lesions ≤1 cm, endoscopic mucosal resection or argon plasma coagulation was preferred. Regarding follow-up endoscopy intervals, most respondents (70.0%) conducted follow-up within 6 months post-endoscopic resection, with subsequent endoscopies at 1-year intervals. This study provides a detailed overview of the current management strategies for LGAs among South Korean gastroenterologists, highlighting the variability in approaches. Further research is required to develop more standardized guidelines for the management and surveillance of LGA.