Endoscopic control of polyp burden and expansion of surveillance intervals in serrated polyposis syndrome

dc.contributor.authorMacPhail, Margaret E.
dc.contributor.authorThygesen, Scott B.
dc.contributor.authorPatel, Nedhi
dc.contributor.authorBroadley, Heather M.
dc.contributor.authorRex, Douglas K.
dc.contributor.departmentMedicine, School of Medicineen_US
dc.date.accessioned2018-12-13T18:24:13Z
dc.date.available2018-12-13T18:24:13Z
dc.date.issued2018
dc.description.abstractIntroduction Serrated polyposis syndrome (SPS) increases colorectal cancer (CRC) risk. We describe the numbers of colonoscopies and polypectomies performed to achieve and maintain low polyp burdens, and the feasibility of expanding surveillance intervals in patients who achieve endoscopic control. Methods We retrospectively evaluated a prospectively collected database on 115 SPS patients undergoing surveillance at Indiana University Hospital between June 2005 and May 2018. The endoscopist provided surveillance interval recommendations based on polyp burden. Endoscopic control was considered successful if surveillance examinations exhibited fewer polyps and if no or only an occasional polyp ≥1 cm in size was present at follow-up. Initial control was designated the clearing phase and the maintenance phase was surveillance after control was established. Results In total, 87 patients (75.7%) achieved endoscopic control, with some others in the clearing phase at this writing. Achieving control required a mean of 2.84 colonoscopies (including the baseline) over 20.4 months and a mean total 27.9 polyp resections. After establishing control, 71 patients were recommended to receive ≥24-month follow-up. Of those, 60 patients (69.0% of patients with initial control) continued surveillance at our center. The mean interval between colonoscopies during maintenance was 19.3 months with 6.74 mean polypectomies per procedure on polyps primarily <1 cm. There were no incident cancers or colon surgeries during maintenance. Conclusion Most patients achieved control of polyp burden with 2 to 3 colonoscopies over 1 to 2 years. After reaching control, 60 patients returned at intervals up to 24 months with no incident cancers and no surgeries required. Expansion of surveillance intervals to 24 months is effective and safe for many SPS patients who reach control of polyp burden.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationMacPhail, M. E., Thygesen, S. B., Patel, N., Broadley, H. M., & Rex, D. K. (2018). Endoscopic control of polyp burden and expansion of surveillance intervals in serrated polyposis syndrome. Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2018.11.016en_US
dc.identifier.urihttps://hdl.handle.net/1805/17985
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.isversionof10.1016/j.gie.2018.11.016en_US
dc.relation.journalGastrointestinal Endoscopyen_US
dc.rightsPublisher Policyen_US
dc.sourceAuthoren_US
dc.subjectserrated polyposis syndromeen_US
dc.subjectpolyp burdenen_US
dc.subjectendoscopic controlen_US
dc.titleEndoscopic control of polyp burden and expansion of surveillance intervals in serrated polyposis syndromeen_US
dc.typeArticleen_US
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