Long-Term Outcome and Surveillance Colonoscopy after Successful Endoscopic Treatment of Large Sessile Colorectal Polyps
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Purpose: Although there is a consensus about the need for surveillance colonoscopy after endoscopic resection, the interval remainscontroversial for large sessile colorectal polyps. The aim of this study was to evaluate the long-term outcome and the adequatesurveillance colonoscopy interval required for sessile and flat colorectal polyps larger than 20 mm. Materials and Methods: A total of 204 patients with large sessile and flat polyps who received endoscopic treatment from May 2005 to November 2011 in a tertiary referral center were included. Results: The mean age was 65.1 years and 62.7% of the patients were male. The mean follow-up duration was 44.2 months and the median tumor size was 25 mm. One hundred and ten patients (53.9%) received a short interval surveillance colonoscopy (median interval of 6.3 months with range of 1–11 months) and 94 patients (46.1%) received a long interval surveillance colonoscopy(median interval of 13.6 months with range of 12–66 months). There were 14 patients (6.9%) who had local recurrence at the surveillance colonoscopy. Using multivariate regression analysis, a polyp size greater than 40 mm was shown to be independent risk factor for local recurrence. However, piecemeal resection and surveillance colonoscopy interval did not significantly influencelocal recurrence. Conclusion: Endoscopic treatment of large sessile colorectal polyps shows a favorable long-term outcome. Further prospective study is mandatory to define an adequate interval of surveillance colonoscopy.
Abstract
Purpose: Although there is a consensus about the need for surveillance colonoscopy after endoscopic resection, the interval remainscontroversial for large sessile colorectal polyps. The aim of this study was to evaluate the long-term outcome and the adequatesurveillance colonoscopy interval required for sessile and flat colorectal polyps larger than 20 mm. Materials and Methods: A total of 204 patients with large sessile and flat polyps who received endoscopic treatment from May 2005 to November 2011 in a tertiary referral center were included. Results: The mean age was 65.1 years and 62.7% of the patients were male. The mean follow-up duration was 44.2 months and the median tumor size was 25 mm. One hundred and ten patients (53.9%) received a short interval surveillance colonoscopy (median interval of 6.3 months with range of 1–11 months) and 94 patients (46.1%) received a long interval surveillance colonoscopy(median interval of 13.6 months with range of 12–66 months). There were 14 patients (6.9%) who had local recurrence at the surveillance colonoscopy. Using multivariate regression analysis, a polyp size greater than 40 mm was shown to be independent risk factor for local recurrence. However, piecemeal resection and surveillance colonoscopy interval did not significantly influencelocal recurrence. Conclusion: Endoscopic treatment of large sessile colorectal polyps shows a favorable long-term outcome. Further prospective study is mandatory to define an adequate interval of surveillance colonoscopy.
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