[Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revised Edition].

Area of Science:

• Gastroenterology
• Oncology
• Preventive Medicine

Background:

• Colonoscopic polypectomy significantly reduces colorectal cancer (CRC) incidence and mortality.
• Premalignant polyps increase the risk of metachronous advanced neoplasia, necessitating effective post-polypectomy surveillance.
• Current surveillance guidelines require refinement due to resource limitations and colonoscopy risks.

Purpose of the Study:

• To develop evidence-based guidelines for post-polypectomy surveillance.
• To identify key predictors of CRC or advanced neoplasia during surveillance colonoscopy.
• To optimize patient management and resource allocation in CRC prevention.

Main Methods:

• An analytic approach was employed to review reliable evidence.
• Predictors of CRC and advanced neoplasia during surveillance were interpreted.
• Consensus guidelines were formulated based on the evidence.

Main Results:

• High-risk findings for metachronous CRC include adenomas ≥10 mm, 3-5+ adenomas, tubulovillous/villous adenomas, adenomas with high-grade dysplasia, traditional serrated adenomas, sessile serrated lesions (SSLs) with dysplasia, large SSLs (≥10 mm), and 3-5+ SSLs.
• These factors indicate an increased risk for developing new or advanced polyps after initial removal.
• Further research is needed to define optimal surveillance intervals and identify patients who benefit most.

Conclusions:

• Specific polyp characteristics and counts are crucial indicators for high-risk post-polypectomy surveillance.
• Refined guidelines can improve the efficiency and effectiveness of CRC surveillance.
• Continued research is essential for personalized surveillance strategies and optimal outcomes.