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- Special Review Korean Guidelines for Post-polypectomy Colonoscopic Surveillance
- Dong-Hoon Yang1, Sung Noh Hong2, Young-Ho Kim3, Sung Pil Hong4, Sung Jae Shin5, Seong-Eun Kim6, Bo In Lee7, Suck-Ho Lee8, Dong Il Park3, Hyun-Soo Kim9, Suk-Kyun Yang1, Hyo Jong Kim10, Se Hyung Kim11, Hyun Jung Kim12, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance
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Intestinal Research 2012;10(1):89-109.
DOI: https://doi.org/10.5217/ir.2012.10.1.89
Published online: February 29, 2012
1Department of Internal Medicine, University of Ulsan College of Medicine
10Wonju, Kyunghee University College of Medicine0
11Seoul, Department of Radiology, Seoul National University College of Medicine1
12Seoul, Department of Preventive Medicine, Korea University College of Medicine2, Seoul, Korea
2Seoul, Konkuk University School of Medicine
3Seoul, Sungkyunkwan University School of Medicine
4Seoul, Yonsei University College of Medicine
5Seoul, Ajou University School of Medicine
6Suwon, Ewha Womans University School of Medicine
7Seoul, The Catholic University of Korea College of Medicine
8Seoul, Soonchunhyang University College of Medicine
9Cheonan, Yonsei University Wonju College of Medicine
10Wonju, Kyunghee University College of Medicine0
11Seoul, Department of Radiology, Seoul National University College of Medicine1
12Seoul, Department of Preventive Medicine, Korea University College of Medicine2, Seoul, Korea
2Seoul, Konkuk University School of Medicine
3Seoul, Sungkyunkwan University School of Medicine
4Seoul, Yonsei University College of Medicine
5Seoul, Ajou University School of Medicine
6Suwon, Ewha Womans University School of Medicine
7Seoul, The Catholic University of Korea College of Medicine
8Seoul, Soonchunhyang University College of Medicine
9Cheonan, Yonsei University Wonju College of Medicine
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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. (Intest Res 2012;10:89-109)
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