Optimal endoscopic treatment and surveillance of serrated polyps
Serrated polyps are considered precursor lesions that account for 15% to 30% of colorectal cancers, and they are overrepresented as a cause of interval cancers. They are difficult to detect and resect comprehensively; however, recent data suggest that high definition endoscopy, chromoendoscopy (via...
| Main Authors: | , |
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| Format: | Journal article |
| Language: | English |
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Editorial Office of Gut and Liver
2019
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| _version_ | 1797104431498526720 |
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| author | Gupta, V East, JE |
| author_facet | Gupta, V East, JE |
| author_sort | Gupta, V |
| collection | OXFORD |
| description | Serrated polyps are considered precursor lesions that account for 15% to 30% of colorectal cancers, and they are overrepresented as a cause of interval cancers. They are difficult to detect and resect comprehensively; however, recent data suggest that high definition endoscopy, chromoendoscopy (via spray catheter, pump or orally), narrow band imaging, split-dose bowel preparation and a slower withdrawal (>6 minutes) can all improve detection. Cold snare resection is effective and safe for these lesions, including cold snare piecemeal endoscopic mucosal resection, which is likely to become the standard of care for lesions >10 mm in size. Sessile serrated lesions ≥10 mm in size, those exhbiting dysplasia, or traditional serrated adenomas increase the chance of future advanced neoplasia. Thus, a consensus is emerging: a surveillance examination at 3 years should be recommended if these lesions are detected. Serrated lesions likely carry equivalent risk to adenomas, so future guidelines may consider serrated class lesions and adenomas together for risk stratification. Patients with serrated polyposis syndrome should undergo surveillance every 1 to 2 years once the colon is cleared of larger lesions, and their first degree relatives should undergo screening every 5 years starting at age 40. |
| first_indexed | 2024-03-07T06:33:41Z |
| format | Journal article |
| id | oxford-uuid:f6e54457-ad87-4edd-910d-10af8574fb4c |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:33:41Z |
| publishDate | 2019 |
| publisher | Editorial Office of Gut and Liver |
| record_format | dspace |
| spelling | oxford-uuid:f6e54457-ad87-4edd-910d-10af8574fb4c2022-03-27T12:38:20ZOptimal endoscopic treatment and surveillance of serrated polypsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f6e54457-ad87-4edd-910d-10af8574fb4cEnglishSymplectic Elements at OxfordEditorial Office of Gut and Liver2019Gupta, VEast, JESerrated polyps are considered precursor lesions that account for 15% to 30% of colorectal cancers, and they are overrepresented as a cause of interval cancers. They are difficult to detect and resect comprehensively; however, recent data suggest that high definition endoscopy, chromoendoscopy (via spray catheter, pump or orally), narrow band imaging, split-dose bowel preparation and a slower withdrawal (>6 minutes) can all improve detection. Cold snare resection is effective and safe for these lesions, including cold snare piecemeal endoscopic mucosal resection, which is likely to become the standard of care for lesions >10 mm in size. Sessile serrated lesions ≥10 mm in size, those exhbiting dysplasia, or traditional serrated adenomas increase the chance of future advanced neoplasia. Thus, a consensus is emerging: a surveillance examination at 3 years should be recommended if these lesions are detected. Serrated lesions likely carry equivalent risk to adenomas, so future guidelines may consider serrated class lesions and adenomas together for risk stratification. Patients with serrated polyposis syndrome should undergo surveillance every 1 to 2 years once the colon is cleared of larger lesions, and their first degree relatives should undergo screening every 5 years starting at age 40. |
| spellingShingle | Gupta, V East, JE Optimal endoscopic treatment and surveillance of serrated polyps |
| title | Optimal endoscopic treatment and surveillance of serrated polyps |
| title_full | Optimal endoscopic treatment and surveillance of serrated polyps |
| title_fullStr | Optimal endoscopic treatment and surveillance of serrated polyps |
| title_full_unstemmed | Optimal endoscopic treatment and surveillance of serrated polyps |
| title_short | Optimal endoscopic treatment and surveillance of serrated polyps |
| title_sort | optimal endoscopic treatment and surveillance of serrated polyps |
| work_keys_str_mv | AT guptav optimalendoscopictreatmentandsurveillanceofserratedpolyps AT eastje optimalendoscopictreatmentandsurveillanceofserratedpolyps |