After a colonoscopy findings12/23/2023 Therefore, caution is required when performing endoscopic resection of many polyps, particularly with repeated resection. The risk of adverse polypectomy events increases with the number of polyps. Post-polypectomy coagulation syndrome occurs in 1.4–3.7% of patients 6, 7, 8, 9, 10. The incidences of ESD-associated delayed bleeding and perforation varies from 1 to 10%, depending on the skill of the endoscopist. The incidences of delayed bleeding and perforation after CSP and EMR vary from 0.3 to 7.2% and from 0.08 to 1.3%, respectively. The adverse events include bleeding and perforation however, these methods are generally considered safe. Depending on the size, shape, and histological diagnosis, various methods can be used, such as cold snare polypectomy (CSP), endoscopic mucosal resection (EMR), and endoscopic submucosal dissection (ESD). However, the strength of the recommendation was weak, and the quality of evidence was very low, indicating the need for further studies on the surveillance strategy after endoscopic removal of > 10 adenomas.Įndoscopic resection is the standard treatment for colon polyps. Interestingly, while the ESGE guidelines do not specify the surveillance colonoscopy interval for those with removal of > 10 adenomas, the USMSTF recommends a 1-year interval for surveillance colonoscopy after endoscopic removal of > 10 adenomas. In addition, the current guideline by the European Society of Gastrointestinal Endoscopy (ESGE) in 2020 also recommends a 3-year interval for surveillance colonoscopy after endoscopic removal of ≥ 5 adenomas 4. Multi-Society Task Force (USMSTF) on Colorectal Cancer in 2020 recommends a 3-year interval for surveillance colonoscopy after endoscopic removal of 5–10 tubular adenomas or ≥ 10 mm because of the increased risk of metachronous advanced neoplasia in patients with multiple adenomas 5. International guidelines suggest the interval of surveillance colonoscopy should be determined according to the baseline colonoscopy findings, such as the number, size, and histology of detected adenomas 4, 5. Therefore, repeat regular surveillance colonoscopy after baseline screening colonoscopy is recommended. Since most colorectal cancers occur through the adenoma-carcinoma sequence, early endoscopic detection and removal of precancerous lesions can lower the incidence of and mortality from colorectal cancer 2, 3. Colonoscopic polypectomy with repeat surveillance colonoscopies is a clinically effective, efficient, and safe management option in patients with ≥ 10 polyps.Ĭolorectal cancer is one of the most common cancers worldwide and the third leading cause of cancer-related death 1. Surveillance colonoscopies identified colorectal cancer only in three patients (2.0%), all of which were mucosal cancers that could be curatively treated by polypectomy. With an increasing number of surveillance colonoscopies, the number of detected polyps and the procedure time decreased. Post-polypectomy bleeding occurred in 6 (3.9%) patients, all of whom were treated conservatively. The mean size of the largest polyp was 13.4 mm. The mean number of polyps detected at the baseline colonoscopy was 20.0, of which 16.0 polyps were endoscopically resected. We also investigated the frequency and interval of surveillance colonoscopies and their findings. We investigated polyp number, polyp size, polypectomy method, procedure time, and adverse events of the baseline colonoscopy. We reviewed the medical records of 152 patients who underwent polypectomy of ≥ 10 polyps at the baseline colonoscopy. We aimed to analyze the clinical outcomes of colonoscopic polypectomy with surveillance colonoscopies in patients with ≥ 10 polyps. .The clinical usefulness of repeat colonoscopic polypectomy in patients with numerous polyps has not been sufficiently determined.
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