Patients with serrated polyposis experience rapid development of colorectal neoplasia and recurrent polyps even after surgery, according to recent study results.
The study was composed of 44 patients with serrated polyposis (mean age at diagnosis 52.5±11.9 years) who had undergone 146 colonoscopies. The median duration between tests was 1.0 years (range 0.5-6), and the median follow-up was 2.0 years (range 0-30). Researchers also collected oesophogastroduodenoscopy and histopathology reports when available. Researchers conducted the study to evaluate the development and progression of colorectal neoplasia and extracolonic polyps.
Additional colorectal polyps were discovered in all patients at surveillance colonoscopies. This included sessile serrated adenomas/polyps (SSA/P) or adenomas, which manifested in 61% of patients at first colonoscopy and in 83% by the final colonoscopy. The average development time of these polyps or adenomas was 1.8±1.5 years (0.5-5). Among all patients, the average increase in polyps per year was 40%, and the mean time in which any recurrent polyps developed was 2.5±2.2 years (0.5-10). Recurrent SSA/P or adenomas were found in 19 participants (68%) on follow-up colonoscopies.
Among seven evaluable patients who underwent surgery, all had recurrent polyps in the retained colorectum following the procedure, including four patients with SSA/P or adenomas found within a mean of 2.5 years after surgery.
“In [serrated polyposis], rapid and unrelenting colorectal neoplasia development continues in the intact colorectum and retained segment after surgery,” the researchers wrote. “These findings support the possibility of annual colonoscopic surveillance, consideration for colectomy when SSA/P or adenomas are encountered and frequent postoperative endoscopic surveillance of the retained colorectum.”