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, requiring effective postpolypectomy surveillance.
• Current surveillance guidelines need refinement due to resource limitations and colonoscopy risks.

Purpose of the Study:

• To develop evidence-based guidelines for postpolypectomy surveillance.
• To identify predictors of CRC or advanced neoplasia during surveillance colonoscopy.
• To optimize surveillance strategies for managing metachronous neoplasia.

Main Methods:

• Consensus guidelines development.
• Analytic approach to review reliable evidence.
• Interpretation of predictors for CRC and advanced neoplasia.

Main Results:

• Identified high-risk findings for metachronous CRC post-polypectomy.
• Key risk factors include adenoma size (≥10 mm), number (3-5+), histology (tubulovillous, villous, high-grade dysplasia), and serrated lesions (traditional serrated adenoma, sessile serrated lesion with dysplasia, ≥10 mm serrated polyp, 3-5+ sessile serrated lesions).

Conclusions:

• Specific polyp characteristics define high-risk patients for metachronous CRC.
• Further research is needed to identify optimal candidates and intervals for surveillance colonoscopy to prevent metachronous CRC.