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Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition

이문성|정윤호|Jong Wook Kim|오은혜|김수영|이오영|천재영|Suyeon Park|Jeong-Sik Byeon|전성란|곽민섭|Soon Man Yoon|Joo Young Cho|Seon-Young Park|Dong Hoon Baek|Soo-Kyung Park|Seung-Joo Nam|Sun-Jin Boo|Seong Ran Jeon|Mi-Young Choi|Hyung Kil Kim
대한소화기내시경학회 (The Korean Society Of Gastrointestinal Endoscopy)|2022.11|Clinical Endoscopy|제55권 제6호|pp. 703-725|DOI 10.5946/ce.2022.136

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키워드

GuidelinesSurveillanceColonoscopyColorectal cancerPolypectomy
주제분류내과학

초록

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discoveredduring colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important meth-od for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance isrequired because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic ap-proach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. Thekey recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size;(2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adeno-ma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance intervalto prevent metachronous CRC.

Abstract

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discoveredduring colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important meth-od for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance isrequired because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic ap-proach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. Thekey recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size;(2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adeno-ma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance intervalto prevent metachronous CRC.

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