Clin Endosc.  2022 Nov;55(6):703-725. 10.5946/ce.2022.136.

Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition

• Kim SY
• Kwak MS
• Yoon SM
• Jung Y
• Kim JW
• Boo SJ
• Oh EH
• Jeon SR
• Nam SJ
• Park SY
• Park SK
• Chun J
• Baek DH
• Choi MY
• Park S
• Byeon JS
• Kim HK
• Cho JY
• Lee MS
• Lee OY
• Korean Society of Gastrointestinal Endoscopy
• Korean Society of Gastroenterology
• Korean Association for the Study of Intestinal Diseases

• KMID: 2536068
• DOI: http://doi.org/10.5946/ce.2022.136

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 the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of 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 to 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 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

Keyword

Colonoscopy; Colorectal cancer; Guidelines; Polypectomy; Surveillance

Figure

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  Fig. 1. Recommendations for postpolypectomy colonoscopic surveillance.

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