2022+韩国指南:息肉切除术后结肠镜监测(修订版).pdf
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1、Korean guidelines for postpolypectomy colonoscopic surveillance:2022 revised editionSu Young Kim1,*,Min Seob Kwak2,*,Soon Man Yoon3,Yunho Jung4,Jong Wook Kim5,Sun-Jin Boo6,Eun Hye Oh7,Seong Ran Jeon8,Seung-Joo Nam9,Seon-Young Park10,Soo-Kyung Park11,Jaeyoung Chun12,Dong Hoon Baek13,Mi-Young Choi14,S
2、uyeon Park15,16,Jeong-Sik Byeon17,Hyung Kil Kim18,Joo Young Cho19,Moon Sung Lee20,Oh Young Lee21,Korean Society of Gastrointestinal Endoscopy,Korean Society of Gastroenterology,Korean Association for the Study of Intestinal Diseases 1Department of Gastroenterology,Wonju Severance Christian Hospital,
3、Yonsei University Wonju College of Medicine,Wonju;2Department of Internal Medicine,Kyung Hee University Hospital at Gangdong,Kyung Hee University School of Medicine,Seoul;3Department of Gastroenterology,Chungbuk National University Hospital,Chungbuk National University College of Medicine,Cheongju;4
4、Department of Internal Medicine,Soonchunhyang University College of Medicine,Cheonan;5Department of Gastroenterology,Inje University Ilsan Paik Hospital,Goyang;6Department of Internal Medicine,Jeju National University School of Medicine,Jeju;7Department of Gastroenterology,Hanyang University Guri Ho
5、spital,Hanyang University College of Medicine,Guri;8Digestive Disease Center,Institute for Digestive Research,Soonchunhyang University College of Medicine,Seoul;9Department of Internal Medicine,Kangwon National University School of Medicine,Chuncheon;10Department of Internal Medicine,Chonnam Nationa
6、l University Medical School,Gwangju;11Department of Internal Medicine,Kangbuk Samsung Hospital,Sungkyunkwan University School of Medicine,Seoul;12Department of Gastroenterology,Gangnam Severance Hospital,Yonsei University College of Medicine,Seoul;13Department of Internal Medicine,Pusan National Uni
7、versity School of Medicine,Busan;14National Evidence-Based Healthcare Collaborating Agency,Seoul;15Department of biostatistics,Soonchunhyang University College of Medicine,Seoul;16Department of Applied Statistics,Chung-Ang University,Seoul;17Department of Gastroenterology,Asan Medical Center,Univers
8、ity of Ulsan College of Medicine,Seoul;18Department of Gastroenterology,Inha University Hospital,Inha University School of Medicine,Incheon;19Department of Gastroenterology,CHA Gangnam Medical Center,Seoul;20Digestive Disease Center,Institute for Digestive Research,Soonchunhyang University College o
9、f Medicine,Bucheon;21Department of Internal Medicine,Hanyang University School of Medicine,Seoul,Korea REVIEW2022 October 13 Epub ahead of printhttps:/doi.org/10.5946/ce.2022.136pISSN:2234-2400 eISSN:2234-2443Received:April 26,2022 Revised:June 12,2022 Accepted:June 22,2022Correspondence:Jeong-Sik B
10、yeon Department of Gastroenterology,Asan Medical Center,University of Ulsan College of Medicine,88 Olympic-ro 43-gil,Songpa-gu,Seoul 05505,Korea E-mail:jsbyeonamc.seoul.kr Correspondence:Oh Young Lee Department of Internal Medicine,Hanyang University School of Medicine,222 Wangsimni-ro,Seongdong-gu,
11、Seoul 04763,Korea E-mail:leeoyhanyang.ac.kr*Su Young Kim and Min Seob Kwak contributed equally to this work as first authors.These guideline is being co-published in Clinical Endoscopy,Intestinal Research,and the Korean Journal of Gastroenterology(in Korean)for the facilitated distribution.Open Acce
12、ssColonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer(CRC).Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia.Postpolypectomy surveillance is the most important meth-od for the management
13、of advanced metachronous neoplasia.A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications.In these consensus guidelines,an analytic ap-proach was used to address all reliable evi
14、dence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy.The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows:(1)adenoma 10 mm in size;(2)3 to 5(or more)adenomas;(3)tubulovillous or villous adenoma;(
15、4)adenoma containing high-grade dysplasia;(5)traditional serrated adeno-ma;(6)sessile serrated lesion(SSL)containing any grade of dysplasia;(7)serrated polyp of at least 10 mm in size;and(8)3 to 5(or more)SSLs.More studies are needed to fully comprehend the patients most likely to benefit from surve
16、illance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.Keywords:Colonoscopy;Colorectal cancer;Guidelines;Polypectomy;Surveillance This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License(http:/creativecommons.o
17、rg/licenses/by-nc/4.0/)which permits unrestricted non-commercial use,distribution,and reproduction in any medium,provided the original work is properly cited.1Copyright 2022 Korean Society of Gastrointestinal EndoscopyINTRODUCTION Colonoscopy is currently a key diagnostic modality for colorec-tal ca
18、ncer(CRC)screening and the establishment of a treatment strategy.CRC remains one of the leading causes of cancer-relat-ed deaths worldwide,despite a decreasing trend in its incidence and mortality owing to the development of screening meth-ods and prevention programs.1 Screening methods to prevent C
19、RC have been presented in various national cohort studies.Among the various methods,colonoscopic polypectomy,which involves the removal of colorectal polyps by colonoscopy,is re-portedly the most effective method for reducing CRC incidence and CRC-related mortality.2,3 Patients with colorectal polyp
20、s are at a high risk of developing colorectal polyps and CRC in the future;thus,appropriate surveillance using colonoscopy after colorectal polyp resection is instrumental.4,5 Additionally,the significance of colonoscopic surveillance lies not only in detect-ing metachronous polyps but also in the d
21、etection of colorectal lesions not detected by index colonoscopy.In Korea,fecal occult blood test has been adopted as a na-tional test to screen for CRC.However,colonoscopy has already been considered for CRC screening because of the character-istics of the healthcare environment in Korea,defined by
22、 its high accessibility and utility of health services,leading to a remarkable increase in the diagnosis and resection of colorectal polyps.6 Although there is no doubt regarding the importance of postpolypectomy colonoscopic surveillance,the method may have a marginal effect on prevention compared
23、to a screening colonoscopy;the likelihood of complications from colonoscopy is also present.Therefore,guidelines for the optimal practice of postpolypectomy colonoscopic surveillance,which max-imizes the benefits and minimizes the possible damage,are required.2,7,8 To establish Korea-specific guidel
24、ines,the Korean Society of Gastroenterology,Korean Society of Gastrointesti-nal Endoscopy,Korean Association for the Study of Intestinal Diseases,and Korean Society of Abdominal Radiology jointly organized a multi-society Taskforce Committee to develop national guidelines for colorectal polyp treatm
25、ent.The Korean Guidelines for Postpolypectomy Colonoscopic Surveillance were first published in 2012 and distributed to health professionals for use in clinical practice.9 Since establishing the first Korean guidelines,many studies have reported postpolypectomy colonoscopic surveillance,ne-cessitati
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