Clinical Endoscopy

Review

Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition: Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases; Clin Endosc 2022;55(6):703-725. Published online October 13, 2022; DOI: https://doi.org/10.5946/ce.2022.136

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Colonoscopic 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 method for the management 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 approach was used to address all reliable evidence 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; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (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 surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

Citations

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Journal of Gastroenterology and Hepatology.2025; 40(2): 433. CrossRef
Minimum Platelet Count Threshold for Safe Colonoscopic Polypectomy: A Large-Scale Propensity Scored-Matched Analysis
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American Journal of Gastroenterology.2025;[Epub] CrossRef
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The Korean Journal of Gastroenterology.2025; 85(2): 137. CrossRef
Prevalence and Characteristics of Colorectal Serrated Polyps
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Journal of Digestive Cancer Research.2025; 13(1): 47. CrossRef
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The Korean Journal of Gastroenterology.2024; 83(4): 143. CrossRef
A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
Intestinal Research.2024; 22(2): 186. CrossRef
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Hyung-Hoon Oh
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The Korean Journal of Medicine.2023; 98(3): 102. CrossRef
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Commentary

Safeness of Endoscopic Resection in Patients with End-Stage Renal Disease on Dialysis: Sun-Jin Boo; Clin Endosc 2020;53(4):381-382. Published online July 30, 2020; DOI: https://doi.org/10.5946/ce.2020.179

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Case Report

Endoscopic Ultrasound-Guided Perirectal Abscess Drainage without Drainage Catheter: A Case Series: Eun Kwang Choi, Ji Hyun Kim, Seung Uk Jeong, Soo-Young Na, Sun-Jin Boo, Heung Up Kim, Byung-Cheol Song; Clin Endosc 2017;50(3):297-300. Published online April 11, 2017; DOI: https://doi.org/10.5946/ce.2016.123

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A perirectal abscess is a relatively common disease entity that occurs as a postsurgical complication or as a result of various medical conditions. Endoscopic ultrasound (EUS)-guided drainage was recently described as a promising alternative treatment. Previous reports have recommended placement of a drainage catheter through the anus for irrigation, which is inconvenient to the patient and carries a risk of accidental dislodgement. We report four cases of perirectal abscess that were successfully treated with only one or two 7 F double pigtail plastic stent placements and without a drainage catheter for irrigation.

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Rectal Endoscopic Ultrasound in Clinical Practice
Stephen Hasak, Vladimir Kushnir
Current Gastroenterology Reports.2019;[Epub] CrossRef

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5 Web of Science
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Original Article

Clipping for the Prevention of Immediate Bleeding after Polypectomy of Pedunculated Polyps: A Pilot Study: Sun-Jin Boo, Jeong-Sik Byeon, Seon Young Park, Jong Sun Rew, Da Mi Lee, Sung Jae Shin, Dong Uk Kim, Geum Am Song; Clin Endosc 2012;45(1):84-88. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.84

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Background/Aims

Immediate postpolypectomy bleeding (IPPB) increases the procedure time and it may disturb performing a safe polypectomy. The purpose of this study is to investigate whether clipping before snare polypectomy of large pedunculated polyps is useful for the prevention of IPPB.

Methods

This is a single arm, pilot study. We enrolled patients with pedunculated colorectal polyps that were 1 cm in size or more from 4 university hospitals between June 2009 and June 2010. Clips were applied at the stalk and snare polypectomy was then performed. The complications, including IPPB, were investigated.

Results

Fifty six pedunculated polyps in 47 patients (Male:Female=36:11; age, 56±11 years) were included. The size of the polyp heads was 17±8 mm. Tubular adenoma was most common (57%). The number of clips used before snare polypectomy was 2±0.5. The procedure was successful in all cases. IPPB occurred in 2 cases (3.6%), and both of these were managed by additional clipping. Delayed bleeding occurred in another one case (1.8%), which improved with conservative treatment. No perforation occurred.

Conclusions

We suggest that clipping before snare polypectomy of pedunculated polyps may be an easy and effective technique for the prevention of IPPB, and this should be confirmed in large scale, prospective, controlled studies.

Citations

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Saudi Journal of Gastroenterology.2021; 27(5): 296. CrossRef
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Vinay Chandrasekhara, Nikhil A. Kumta, Barham K. Abu Dayyeh, Manoop S. Bhutani, Pichamol Jirapinyo, Kumar Krishnan, John T. Maple, Joshua Melson, Rahul Pannala, Mansour A. Parsi, Amrita Sethi, Guru Trikudanathan, Arvind J. Trindade, David R. Lichtenstein
VideoGIE.2021; 6(7): 283. CrossRef
Prophylactic clip application for large pedunculated polyps before snare polypectomy may decrease immediate postpolypectomy bleeding
Jae Seung Soh, Myeongsook Seo, Kyung-Jo Kim
BMC Gastroenterology.2020;[Epub] CrossRef
Management of colonic polyps: an advancing discipline
Amir Klein, Michael J. Bourke
ANZ Journal of Surgery.2017; 87(5): 327. CrossRef
Massive post‐polypectomy hemorrhage: Successful tulip‐bundle technique with endoloop for hemostasis
Hsu‐Heng Yen, Chia‐Wei Yang, Shun‐Sheng Wu, Maw‐Soan Soon
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Amir Klein, Michael J. Bourke
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Comparison of clipping with and without epinephrine injection for the prevention of post‐polypectomy bleeding in pedunculated colon polyps
Yehyun Park, Tae Joo Jeon, Ji Young Park, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Sung Pil Hong
Journal of Gastroenterology and Hepatology.2015; 30(10): 1499. CrossRef
Endoscopic haemostasis: An overview of procedures and clinical scenarios
Jérémie Jacques, Romain Legros, Stanislas Chaussade, Denis Sautereau
Digestive and Liver Disease.2014; 46(9): 766. CrossRef
Advanced Endoscopic Resection of Colorectal Lesions
Andres Sanchez-Yague, Tonya Kaltenbach, Gottumukkala Raju, Roy Soetikno
Gastroenterology Clinics of North America.2013; 42(3): 459. CrossRef
A Cost-efficacy Decision Analysis of Prophylactic Clip Placement After Endoscopic Removal of Large Polyps
Neehar D. Parikh, Kyle Zanocco, Rajesh N. Keswani, Andrew J. Gawron
Clinical Gastroenterology and Hepatology.2013; 11(10): 1319. CrossRef
Fat Polyp, Thin Blood: Think Clip!
Laura Borodyansky, John R. Saltzman
Clinical Gastroenterology and Hepatology.2013; 11(10): 1333. CrossRef

10,158 View
91 Download
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