Korean Guidelines for Post-polypectomy Colonoscopic Surveillance.
- Author:
Sung Noh HONG
1
;
Dong Hoon YANG
;
Young Ho KIM
;
Sung Pil HONG
;
Sung Jae SHIN
;
Seong Eun KIM
;
Bo In LEE
;
Suck Ho LEE
;
Dong Il PARK
;
Hyun Soo KIM
;
Suk Kyun YANG
;
Hyo Jong KIM
;
Se Hyung KIM
;
Hyun Jung KIM
Author Information
- Publication Type:Review ; English Abstract ; Practice Guideline ; Research Support, Non-U.S. Gov't
- Keywords: Colorectal polyp; Colonoscopy; Polypectomy; Surveillance; Guideline
- MeSH: Adenoma/*diagnosis/surgery; Adenoma, Villous/diagnosis/surgery; Colonic Polyps/pathology/*surgery; *Colonoscopy; Colorectal Neoplasms/*diagnosis/surgery; Databases, Factual; Humans; Republic of Korea; Risk Factors; Time Factors
- From:The Korean Journal of Gastroenterology 2012;59(2):99-117
- CountryRepublic of Korea
- Language:Korean
- Abstract: Post-polypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. However, because the medical resource is limited, and the first screening colonoscopy produces the greatest effect on reducing the incidence and mortality of colorectal cancer, there is a need to increase the efficiency of postpolypectomy surveillance. In the present report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy. Based on the results of review of the evidences, we elucidated the high risk findings of the index colonoscopy as follows: 1) 3 or more adenomas, 2) any adenoma larger than 10 mm, 3) any tubulovillous or villous adenoma, 4) any adenoma with high-grade dysplasia, and 5) any serrated polyps larger than 10 mm. In patients without any high-risk findings at the index colonoscopy, surveillance colonoscopy should be performed five years after index colonoscopy. In patients with one or more high risk findings, surveillance colonoscopy should be performed three years after polypectomy. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polyp removal, the patient's general condition, and family and medical history. This practical guideline cannot totally take the place of clinical judgments made by practitioners and should be revised and supplemented in the future as new evidence becomes available.
