Riktlinjer för endoskopisk kontroll efter kolorektal polypektomi.

Endoscopic surveillance after colorectal polypectomy 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 co-morbidity of the patients as well as findings at previous colonoscopies.