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Korean J Gastroenterol.  2022 Sep;80(3):115-134. 10.4166/kjg.2022.103.

Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revised Edition

Affiliations
  • 1Department of Gastroenterology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 2Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
  • 3Department of Gastroenterology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 4Division of Gastroenterology, Department of Internal Medicine, Soon Chun Hyang University Cheonan Hospital, Cheonan, Korea.
  • 5Department of Gastroenterology, Inje University Ilsan Paik Hospital, Goyang, Korea.
  • 6Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
  • 7Department of Gastroenterology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
  • 8Digestive Disease Center, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 9Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
  • 10Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
  • 11Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 12Department of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 13Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
  • 14National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
  • 15Department of Biostatistics, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 16Department of Applied Statistics, Chung-Ang University, Seoul, Korea.
  • 17Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 18Department of Gastroenterology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
  • 19Department of Gastroenterology, CHA Gangnam Medical Center, Seoul, Korea.
  • 20Division of Gastroenterology, Department of Internal Medicine, Soon Chun Hyang University Bucheon Hospital, Bucheon, Korea.
  • 21Department of Internal Medicine, Hanyang University School of Medicine, Seoul, Korea, Korea.

Abstract

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for managing advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of the limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: 1) adenoma ≥10 mm in size; 2) 3-5 (or more) adenomas; 3) tubulovillous or villous adenoma; 4) adenoma containing high-grade dysplasia; 5) traditional serrated adenoma; 6) sessile serrated lesion (SSL) containing any grade of dysplasia; 7) serrated polyp of at least 10 mm in size; and 8) 3-5 (or more) SSLs. More studies are needed to fully comprehend the patients who are most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

Keyword

Colonoscopy; Colorectal cancer; Guideline; Polypectomy; Surveillance

Figure

  • Fig. 1 Recommendations for post-polypectomy colonoscopic surveillance.


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