Observational studyDigestive diseases and sciences2026
Surveillance Outcomes in an Australian Cohort Undergoing Piecemeal Polypectomy for Conventional Adenomas and Serrated Lesions.
Observational study in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
BACKGROUND AND
aimsCurrent guidelines recommend early surveillance following piecemeal polypectomy due to recurrence risk; however, this contributes substantially to colonoscopy burden. We aimed to identify subgroups in which surveillance can be safely deferred beyond current guideline intervals.
methodsWe performed a two-center retrospective study of consecutive patients undergoing first (SC1) and second (SC2) surveillance colonoscopy following piecemeal resection. Primary outcome was histological recurrence; secondary outcome was detection of additional high-risk polyps.
resultsA total of 221 lesions, 130 conventional adenomas (CA) and 91 serrated lesions (SL), were resected piecemeal in 202 patients, with 76% removed using cold snare technique. Recurrence following cold resection occurred in 11% of CA ≥ 20 mm and 15% of CA < 20 mm, while recurrence in SL was low (5% for < 20 mm; 0% for ≥ 20 mm). Hot snare resection was predominantly used for larger CA (79% ≥ 20 mm) and was associated with a recurrence rate of 14%. At SC1, additional high-risk polyps were detected in 27% of patients, particularly following resection of larger index lesions. No advanced neoplasia was detected at SC2 in patients with serrated lesions without recurrence at SC1.
conclusionsIn this real-world study, most piecemeal polypectomy was performed using cold snare technique. There was a clinically significant risk of recurrence in CA including those < 20 mm supporting current recommendations of surveillance at 6 months unless technical advances can be shown to reduce recurrence. Our findings suggest a lower risk of recurrence in SL of all sizes and if confirmed on further studies, surveillance intervals may be able to safely lengthen in these cases.
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