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Intest Res > Volume 10(1); 2012 > Article
Intestinal Research 2012;10(1):89-109.
DOI: https://doi.org/10.5217/ir.2012.10.1.89    Published online February 29, 2012.
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
1Department of Internal Medicine, University of Ulsan College of Medicine
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
폴립절제 후 추적대장내시경검사 가이드라인
양동훈11, 홍성노2, 김영호3, 홍성필4, 신성재5, 김성은6, 이보인7, 이석호8, 박동일3, 김현수9, 양석균1, 김효종10, 김세형11, 김현정다학회기반대장폴립진료12, 다학회기반대장폴립진료가이드라인개발실무위원회
1울산대학교 의과대학
2건국대학교 의학전문대학원
3성균관대학교 의과대학
4연세대학교 의과대학
5아주대학교 의과대학
6이화여자대학교 의학전문대학원
7가톨릭대학교 의과대학
8순천향대학교 의과대학
9연세대학교 원주의과대학
10경희대학교 의과대학 내과학교실
11서울대학교 의과대학 영상의학교실
12고려대학교 의과대학 예방의학교실
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)
Key Words: Colorectal Polyp, Colonoscopy, Polypectomy, Surveillance, Guidelines
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