New Guidelines on Post-polypectomy Colonoscopy Surveillance

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.

Keywords: Colorectal cancer prevention, Guidelines, Polypectomy, Surveillance, Timing of the second colonoscopy.