Riktlinjer för endoskopisk kontroll efter kolorektal polypektomi

These guidelines for endoscopic surveillance after colorectal polypectomy are based on the recommendations published by European Society of Gastrointestinal Endoscopy (ESGE) in 2013. A precondition for the guidelines is that patients have undergone a high-quality colonoscopy, including complete removal and histopathological evaluation of all detected neoplastic lesions. Current research has made it possible to stratify patients into a low-risk and a high-risk group in terms of metachronous cancer. Low-risk group patients (1-2 tubular adenomas <10 mm in size) are recommended a surveillance colonoscopy 10 years after the index colonoscopy if the patient is less than 50 years old, otherwise not. High-risk group patients (adenomas with villous histology or high grade dysplasia or ≥10 mm in size, or ≥ 3 adenomas), should undergo a repetition colonoscopy 3 years after the index colonoscopy. If high-risk adenomas are detected at first or subsequent surveillance colonoscopy, a 3-year repetition of the next endoscopic examination is recommended. If a high-risk patient has no high-risk adenomas at the first surveillance colonoscopy, a 5-year period is recommended until the second surveillance colonoscopy. ESGE recommends termination of the follow-up at 80 years of age although individualised recommendations should consider general health and comorbidity of the patients as well as findings at previous colonoscopies.