New Guidelines on Post-polypectomy Colonoscopy Surveillance
Pp. 134-144 (11)
Colorectal cancer (CRC) remains a frequent tumor, in spite of the screening
programs developed in most of the countries. It is well known that CRC is developing
from polyps and that the polypectomy prevents the CRC and ultimately the death of the
patient. One important debate is about the post polypectomy surveillance of the
patients, in regard to the timing of the second colonoscopy after the baseline one.
Appropriate intervals spare the patient from an unwanted colonoscopy, however, in the
case of advanced lesions ensures no recurrence of the lesion. Last year, important
guidelines were elaborated and revised by different societies. This chapter is
summarizing the recent European, American and British guidelines which are mostly
similar, with small exceptions. The updated guidelines are reducing the number of
colonoscopies in patients with small adenoma and serrated polyps without dysplasia.
The villous proportion of a polyp is not considered a risk factor. In the piece-meal
resection is indicated a shorter period to reevaluate the patient to reduce the risk of
incomplete resection. The present guidelines are decreasing the unnecessary
colonoscopies in patients that are considered with no risk, reducing the costs and
ensuring a better psychical comfort for the patients.
Colorectal cancer prevention, Guidelines, Polypectomy, Surveillance,
Timing of the second colonoscopy.