Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2020
Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2020
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DOI：
10.1055/a-1185-3109
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发表时间：
2020-07-26
期刊：
影响因子：
9.3
通讯作者：
Quintero, Enrique
中科院分区：
文献类型：
--
作者：
Hassan, Cesare;Antonelli, Giulio;Quintero, Enrique
以下关于息肉切除术后结肠镜监测的建议适用于在高质量基线结肠镜检查期间完全切除一个或多个息肉的所有患者。1ESGE 建议完全切除 1 – 4 < 10 mm 腺瘤且伴有低度不典型增生的患者，无论绒毛成分如何，或任何锯齿状息肉 < 10 mm 无不典型增生，不需要内镜监测并应返回强推荐，中等质量证据。如果无法进行有组织的筛查，建议在初次手术后 10 年重复进行结肠镜检查。强推荐，中等质量证据。2ESGE 建议对至少 1 个腺瘤 ≥ 10 mm 或高度不典型增生、或 ≥5 个腺瘤或任何锯齿状息肉 ≥ 10 mm 完全切除或伴有强烈推荐，中等质量证据。3ESGE 建议在分段内镜切除≥20mm 的息肉后，提前 3–6 个月重复结肠镜检查。强烈推荐，中等质量证据。建议重复结肠镜检查 12 个月后进行第一次结肠镜检查，以检测晚期复发。强烈推荐，高质量证据。4如果在第一次监测结肠镜检查时没有检测到需要监测的息肉，ESGE 建议进行第二次监测5年后进行结肠镜检查。推荐弱，证据质量低。此后，如果没有检测到需要监测的息肉，患者可以返回筛查。5ESGE建议，如果在第一次或随后的监测检查中检测到需要监测的息肉，则可以在3年后进行监测结肠镜检查。推荐弱，证据质量低。提供了显示推荐监测间隔的流程图（图 1）。
The following recommendations for post-polypectomy colonoscopic surveillance apply to all patients who had one or more polyps that were completely removed during a high quality baseline colonoscopy.1ESGE recommends that patients with complete removal of 1 – 4 < 10 mm adenomas with low grade dysplasia, irrespective of villous components, or any serrated polyp < 10 mm without dysplasia, do not require endoscopic surveillance and should be returned to screening.Strong recommendation, moderate quality evidence.If organized screening is not available, repetition of colonoscopy 10 years after the index procedure is recommended.Strong recommendation, moderate quality evidence.2ESGE recommends surveillance colonoscopy after 3 years for patients with complete removal of at least 1 adenoma ≥ 10 mm or with high grade dysplasia, or ≥ 5 adenomas, or any serrated polyp ≥ 10 mm or with dysplasia.Strong recommendation, moderate quality evidence.3ESGE recommends a 3 – 6-month early repeat colonoscopy following piecemeal endoscopic resection of polyps ≥ 20 mm.Strong recommendation, moderate quality evidence.A first surveillance colonoscopy 12 months after the repeat colonoscopy is recommended to detect late recurrence.Strong recommendation, high quality evidence.4If no polyps requiring surveillance are detected at the first surveillance colonoscopy, ESGE suggests to perform a second surveillance colonoscopy after 5 years.Weak recommendation, low quality evidence.After that, if no polyps requiring surveillance are detected, patients can be returned to screening.5ESGE suggests that, if polyps requiring surveillance are detected at first or subsequent surveillance examinations, surveillance colonoscopy may be performed at 3 years.Weak recommendation, low quality evidence.A flowchart showing the recommended surveillance intervals is provided (Fig. 1).