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Endoscopy 2013; 45(10): 842-864
DOI: 10.1055/s-0033-1344548
Guidelines
© Georg Thieme Verlag KG Stuttgart · New York

Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Cesare Hassan
1   Digestive Endoscopy Unit, Catholic University, Rome, Italy
,
Enrique Quintero
2   Gastroenterology Department, Hospital Universitario de Canarias–La Laguna University, Spain
3   Oncology Group, Asociación Española de Gastroenterología, Spain
,
Jean-Marc Dumonceau
4   Division of Gastroenterology and Hepatology, Geneva University Hospitals; Geneva, Switzerland
,
Jaroslaw Regula
5   Department of Gastroenterology, Maria Sklodowska-Curie Memorial Cancer Center and Medical Centre for Postgraduate Education, Warsaw, Poland
,
Catarina Brandão
6   Gastroenterology Department, Oporto Oncology Institute, Oporto, Portugal
,
Stanislas Chaussade
7   Department of Gastroenterology, Cochin Hospital, Paris, France
,
Evelien Dekker
8   Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
,
Mario Dinis-Ribeiro
6   Gastroenterology Department, Oporto Oncology Institute, Oporto, Portugal
,
Monika Ferlitsch
9   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
,
Antonio Gimeno-García
2   Gastroenterology Department, Hospital Universitario de Canarias–La Laguna University, Spain
3   Oncology Group, Asociación Española de Gastroenterología, Spain
,
Yark Hazewinkel
8   Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
,
Rodrigo Jover
3   Oncology Group, Asociación Española de Gastroenterología, Spain
10   Gastroenterology Department, Hospital General Universitario de Alicante, Spain
,
Mette Kalager
11   Department of Clinical Research, Telemark Hospital, Skien, Norway
12   Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
,
Magnus Loberg
12   Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
13   Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway
,
Christian Pox
14   Department of Medicine, Ruhr-Universität Bochum, Knappschaftskrankenhaus, Bochum, Germany
,
Bjorn Rembacken
15   Centre for Digestive Diseases, The General Infirmary at Leeds, Leeds, United Kingdom
,
David Lieberman
16   Oregon Health and Science University, Portland, Oregon
› Author Affiliations
Further Information

Publication History

submitted 01 January 1001

accepted after revision 01 January 1001

Publication Date:
12 September 2013 (online)

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This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence.

Main recommendations: The following recommendations for post-polypectomy endoscopic surveillance should be applied only after a high quality baseline colonoscopy with complete removal of all detected neoplastic lesions.

1 In the low risk group (patients with 1 – 2 tubular adenomas < 10 mm with low grade dysplasia), the ESGE recommends participation in existing national screening programmes 10 years after the index colonoscopy. If no screening programme is available, repetition of colonoscopy 10 years after the index colonoscopy is recommended (strong recommendation, moderate quality evidence).

2 In the high risk group (patients with adenomas with villous histology or high grade dysplasia or ≥10 mm in size, or ≥ 3 adenomas), the ESGE recommends surveillance colonoscopy 3 years after the index colonoscopy (strong recommendation, moderate quality evidence). Patients with 10 or more adenomas should be referred for genetic counselling (strong recommendation, moderate quality evidence).

3 In the high risk group, if no high risk adenomas are detected at the first surveillance examination, the ESGE suggests a 5-year interval before a second surveillance colonoscopy (weak recommendation, low quality evidence). If high risk adenomas are detected at first or subsequent surveillance examinations, a 3-year repetition of surveillance colonoscopy is recommended (strong recommendation, low quality evidence).

4 The ESGE recommends that patients with serrated polyps < 10 mm in size with no dysplasia should be classified as low risk (weak recommendation, low quality evidence). The ESGE suggests that patients with large serrated polyps (≥ 10 mm) or those with dysplasia should be classified as high risk (weak recommendation, low quality evidence).

5 The ESGE recommends that the endoscopist is responsible for providing a written recommendation for the post-polypectomy surveillance schedule (strong recommendation, low quality evidence).

Appendix e1 and e2, Table e1 – e8,