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 postpolypectomy surveillance.
• Current surveillance guidelines require refinement due to resource limitations and colonoscopy-related risks.

Purpose of the Study:

• To develop evidence-based consensus guidelines for postpolypectomy surveillance.
• To identify key predictors of metachronous CRC or advanced neoplasia during surveillance colonoscopy.
• To optimize the management of patients following polyp removal.

Main Methods:

• Systematic review and analytic approach to evaluate reliable evidence.
• Identification and interpretation of predictors for CRC and advanced neoplasia.
• Development of consensus recommendations based on evidence.

Main Results:

• High-risk findings for metachronous CRC include large adenomas (≥10 mm), multiple adenomas (3-5+), tubulovillous/villous adenomas, adenomas with high-grade dysplasia, traditional serrated adenomas, sessile serrated lesions (SSLs) with dysplasia, large SSLs (≥10 mm), and multiple SSLs (3-5+).

Conclusions:

• Specific polyp characteristics identify patients at high risk for metachronous CRC.
• Further research is needed to define optimal surveillance intervals and patient selection criteria.
• Evidence-based guidelines are crucial for efficient and effective postpolypectomy surveillance.