Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer
Colonoscopy is performed routinely for colorectal cancer (CRC) screening, follow-up of other abnormal screening tests, workup of signs and symptoms of gastrointestinal disease, and surveillance after CRC and polyp removal. Post procedure, colonoscopists are expected to provide follow-up recommendations to patients and referring physicians. Recommendations for follow-up after normal colonoscopy among individuals age-eligible for screening, and post-polypectomy among all individuals with polyps are among the most common clinical scenarios requiring guidance.
Conclusion Incomplete polyp resection was frequent after polypectomy in routine clinical practice. Serrated histology and proximal location were independent risk factors for incomplete resection. The performance of board-certified gastroenterologists was not superior to that of trainees. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents | Abstract | Full text
Conclusion As previously demonstrated for hospital patients, screening participants classified as intermediate risk comprised two risk subgroups. Surveillance clearly benefited the higher-risk subgroup. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | open access Full text
Conclusions In an organized screening program, post-colonoscopy adverse events were rare but not negligible. The most frequent event was post-polypectomy bleeding, especially after resection of large (≥ 20 mm) and proximal lesions. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents | Abstract | Full text
CONCLUSIONS: Our study highlights the lack of uniformity of tattoo practice among endoscopists. Despite the National Bowel Cancer Screening Programme guidelines, a significant proportion of colorectal lesions are still not tattooed during their first endoscopy. Some patients had to have repeat endoscopy just for the purpose of tattooing. Active involvement and participation of all endoscopists in the colorectal and the complex polyp multidisciplinary teams may help to improve the tattoo service. PMID: 32538104 [PubMed - as supplied by publisher]
ConclusionOur results suggest thatBRAF-mutant and CIMP-high serrated polyps are not associated with subsequent advanced colorectal neoplasia. Among SSA/Ps,MLH1 methylation may be an important marker to identify high-risk CRC precursors.
Postpolypectomy bleeding and incomplete polyp removal are important complication and quality concerns of colonoscopy for colon cancer prevention. Endoscopic mucosal stripping (EMS) is a modified extension of traditional cold snare polypectomy to avoid submucosal injury during removal of non-pedunculated colon polyps. We previously demonstrated EMS could potentially eliminate postpolypectomy bleeding, especially for advanced colon polyps, and facilitate complete polyp removal based on polypectomy site biopsy and short-term follow-up colonoscopy (1,2).
We reported retrospective data that compared with CO2 insufflation, water exchange (WE) colonoscopy significantly reduced rAMR (17.5% vs. 33.8%, P=0.034) (BMC Gastroenterol 2019;19:143). We performed a prospective randomized controlled trial (RCT) of WE and CO2 insufflation to determine whether WE with near-complete removal of infused water during insertion could reduce rAMR and rAMR combined with right colon hyperplastic polyp miss rate (rHPMR).
Incomplete resection of neoplastic colorectal polyps can cause of post-colonoscopy colorectal cancer. This systematic review and meta-analysis aimed to determine the incomplete resection rate (IRR) of colorectal polyps and associated factors.
Colonoscopy is considered to be the preferred modality for colo-rectal cancer (CRC) screening because it has both diagnostic and therapeutic capabilities. Current consensus dictates that colonoscopy be performed with rapid passage of the instrument through the loops and bends of the colon to the cecum. The time taken for this is called cecal intubation time (CIT). This is then followed by thorough evaluation for and removal of all polyps during a slow deliberate withdrawal, the time taken for which is called withdrawal time.
Colorectal polyps such as adenomas and serrated polyps are precursors for colorectal cancer (CRC). Therefore, removal of such polyps reduces CRC risk.1 Patients who had adenomas or serrated polyps removed at colonoscopy are believed to be at increased risk of developing more polyps later in life and eventually CRC.2,3 Thus, colonoscopy surveillance after polyp removal is currently recommended.4