| Theme | Surveillance after Treatment for Colorectal Tumors | |
|---|---|---|
| Title | Colonoscopy Surveillance after Removal of Sessile Serrated Adenoma / Polyps | |
| Publish Date | 2018/07 | |
| Author | Wataru Sano | Gastrointestinal Center, Sano Hospital |
| Author | Yasushi Sano | Gastrointestinal Center, Sano Hospital |
| [ Summary ] | Among colorectal serrated lesions, sessile serrated adenoma/polyps (SSA/Ps) are considered to be premalignant lesions that rapidly progress to carcinomas after developing cytological dysplasia (CD). Although treatment strategies comprising removal of all SSA/Ps are available in Western countries, no treatment strategy for SSA/Ps has been established in Japan. The results of our study revealed that the rate of CD within SSA/Ps significantly increased with lesion size (≤ 5 mm, 0 %; 6-9 mm, 6.0 %; and ≥ 10 mm, 13.6 %), leading to our proposition of removing all SSA/Ps ≥ 6 mm. Conversely, SSA/Ps ≤ 5 mm can be left in situ considering that they are unlikely to be accompanied by CD. Surveillance colonoscopy should be performed within three years of the removal of SSA/Ps. In addition, SSA/Ps are often characterized by indistinct lesion borders and high incomplete resection rates, thereby necessitating explicit confirmation of the absence of remnant lesions after the removal of SSA/Ps to avoid development of interval cancers. |
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