Clin Endosc.  2012 Mar;45(1):44-61. 10.5946/ce.2012.45.1.44.

Korean Guidelines for Postpolypectomy Colonoscopy Surveillance

Affiliations
  • 1Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea. younghokim@skku.edu
  • 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.
  • 6Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
  • 9Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 10Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
  • 11Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
  • 12Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.

Abstract

Postpolypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. In this report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy and we elucidated the high risk findings of the index colonoscopy as follows: 3 or more adenomas, any adenoma larger than 10 mm, any tubulovillous or villous adenoma, any adenoma with high-grade dysplasia, and any serrated polyps larger than 10 mm. Surveillance colonoscopy should be performed five years after the index colonoscopy for those without any high-risk findings and three years after the index colonoscopy for those with one or more high risk findings. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polypectomy, the patient's general condition, and family and medical history.

Keyword

Guideline; Colonoscopy; Colorectal neoplasms; Surveillance; Polypectomy

MeSH Terms

Adenoma
Adenoma, Villous
Colonoscopy
Colorectal Neoplasms
Humans
Korea
Mass Screening
Polyps

Figure

  • Fig. 1 Flow chart outlining search process used to identify articles for inclusion in systematic review and meta-analysis.

  • Fig. 2 Forest plot for the number of colorectal adenomas as a risk factor for advanced neoplasia. CI, confidence interval.

  • Fig. 3 Forest plot for the size of colorectal adenomas as a risk factor for advanced neoplasia. CI, confidence interval.

  • Fig. 4 Forest plot for villous/tubulovillous adenomas as a risk factor for advanced neoplasia. CI, confidence interval, TA, tubular adenoma.

  • Fig. 5 Forest plot for adenomas with high grade dysplasia as a risk factor for advanced neoplasia. CI, confidence interval.

  • Fig. 6 Forest plot of the large (≥10 mm) serrated polyps at index colonoscopy as a risk factor for advanced neoplasia. CI, confidence interval.

  • Fig. 7 Forest plot for the location of index polyps as a risk factor for advanced neoplasia. CI, confidence interval.

  • Fig. 8 Forest plot for the gender as a risk factor for advanced neoplasia. CI, confidence interval.

  • Fig. 9 Forest plot for the family history of colorectal cancers as a risk factor for advanced neoplasia. CI, confidence interval.


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