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
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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 |
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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) |
Key Words:
Colorectal Polyp, Colonoscopy, Polypectomy, Surveillance, Guidelines |
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