Abstract:
Recently, updated guidelines for post-polypectomy surveillance have been published by the U.S. Multi-Society Task Force (USMSTF), the British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE), the European Society of Gastrointestinal Endoscopy (ESGE), the Japan Gastroenterological Endoscopy Society (JGES), and the Korean Multi-Society Taskforce Committee. This review summarizes and compares the updated recommendations of these 5 guidelines. There are some differences between the guidelines for the recommended post-polypectomy surveillance intervals. In particular, there are prominent differences between the guidelines for 1-4 tubular adenomas < 10 mm with low-grade dysplasia (nonadvanced adenomas [NAAs]) and tubulovillous or villous adenomas. The USMSTF, JGES, and Korean guidelines recommend colonoscopic surveillance for patients with 1-4 NAAs and those with tubulovillous or villous adenomas, whereas the BSG/ACPGBI/PHE and ESGE guidelines do not recommend endoscopic surveillance for such patients. Surveillance recommendations for patients with serrated polyps (SPs) are limited. Although the USMSTF guidelines provide specific recommendations for patients who have undergone SPs removal, these are weak and based on very lowquality evidence. Future studies should examine this topic to better guide the surveillance recommendations for patients with SPs. For countries that do not have separate guidelines, we hope that this review article will help select the most appropriate guidelines as per each country\'s healthcare environment.
摘要:
最近,美国多社会工作组(USMSTF)发布了最新的息肉切除术后监测指南,英国胃肠病学会/大不列颠及爱尔兰结肠直肠学协会/英国公共卫生(BSG/ACPGBI/PHE),欧洲胃肠内窥镜学会(ESGE),日本胃肠病学内窥镜学会(JGES),和韩国多社会工作组。本综述总结并比较了这5条指南的最新建议。推荐的息肉切除术后监测间隔的指南之间存在一些差异。特别是,指南对1-4例<10mm管状腺瘤伴低度发育不良(非晚期腺瘤[NAAs])和肾小管绒毛状或绒毛状腺瘤有显著差异.USMSTF,JGES,韩国指南建议对1-4个NAA患者和肾小管绒毛或绒毛腺瘤患者进行结肠镜监测,而BSG/ACPGBI/PHE和ESGE指南不建议对此类患者进行内镜监测.对锯齿状息肉(SP)患者的监测建议有限。尽管USMSTF指南为接受SPs切除的患者提供了具体建议,这些是薄弱的,基于非常低质量的证据。未来的研究应该检查这个主题,以更好地指导SPs患者的监测建议。对于没有单独准则的国家,我们希望这篇评论文章将有助于根据每个国家的医疗保健环境选择最合适的指南。