[Endoscopic surveillance after colorectal polypectomy].

Area of Science:

• Gastroenterology
• Endoscopy
• Oncology

Background:

• Colorectal cancer surveillance after polypectomy is crucial for detecting metachronous lesions.
• Guidelines for endoscopic surveillance have evolved based on risk stratification.
• High-quality colonoscopy with complete polyp removal and histopathological evaluation is a prerequisite.

Purpose of the Study:

• To provide updated guidelines for endoscopic surveillance after colorectal polypectomy.
• To stratify patients into low-risk and high-risk groups for metachronous cancer.
• To define surveillance intervals and termination criteria.

Main Methods:

• Based on European Society of Gastrointestinal Endoscopy (ESGE) 2013 recommendations.
• Stratification of patients into low-risk (1-2 small tubular adenomas) and high-risk (villous histology, high-grade dysplasia, large or multiple adenomas) groups.
• Defined surveillance colonoscopy intervals: 10 years for low-risk (if <50 years old), 3 years for high-risk, with subsequent intervals of 3 or 5 years based on findings.

Main Results:

• Low-risk patients (<50 years) require surveillance colonoscopy 10 years post-polypectomy.
• High-risk patients require repeat colonoscopy in 3 years.
• Subsequent surveillance for high-risk patients is 3 years if high-risk adenomas persist, or 5 years if none are found.

Conclusions:

• Surveillance colonoscopy intervals should be tailored based on patient risk stratification post-polypectomy.
• Follow-up can be terminated at age 80, considering individual health and previous findings.
• Adherence to high-quality colonoscopy and polyp evaluation is essential for effective surveillance.