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KMID : 1038120220550060703
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Clinical Endoscopy
2022 Volume.55 No. 6 p.703 ~ p.725
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Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition
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Kim Soo-Young
Kwak Min-Seob
Yoon Soon-Man
Jung Yun-Ho
Kim Jong-Uk
Boo Seon-Jin
Oh Eun-Hye
Jeon Seong-Ran
Nam Seung-Joo
Park Seon-Young
Park Soo-Kyung
Baek Dong-Hoon
Choi Mi-Young
Park Su-Yeon
Byeon Jeong-Sik
Kim Hyung-Gil
Cho Joo-Young
Lee Moon-Sung
Lee Oh-Young
Chun Jae-Young
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Abstract
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Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key 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 adenoma; (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 interval to prevent metachronous CRC.
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KEYWORD
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Colonoscopy, Colorectal cancer, Guidelines, Polypectomy, Surveillance
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