ArticleSurgical endoscopy2026
A "resect and discard" strategy with risk-stratified management based on polyp diameter, number, and resection history.
Article in Surgical endoscopy, 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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Abstract
backgroundCurrent "resect and discard" strategies, which rely on advanced optical diagnosis or artificial intelligence, face challenges in widespread adoption because of high technological and equipment requirements.
methodsWe retrospectively analyzed data from patients who underwent complete endoscopic resection of colorectal polyps with a definitive pathological diagnosis at Hangzhou Ninth Hospital between May 2015 and July 2025. Different "resect and discard" strategies and recommended endoscopic follow-up intervals were formulated based on polyp diameter and number. The concordance between the follow-up intervals suggested by our strategy and those recommended by current pathology-based guidelines was analyzed. This strategy was further validated in patients who underwent follow-up after their initial polypectomy.
resultsA total of 7,265 patients (mean age 56.34 years, 63.0% male) with 10,004 polyps were included in the study. Polyps ≤ 5 mm constituted the greatest proportion (86.4%), while the incidence of high-risk polyps was low (0.35%). The "resect and discard" strategy applied to patients with 1-2 polyps ≤ 5 mm demonstrated high applicability (80.11%) and excellent agreement with guideline-recommended surveillance intervals (99.59%; 95% CI: 0.994-0.997). A significant difference was observed in the proportion of high-risk polyps among resected 6-9 mm polyps between patients who underwent their first polypectomy and those in the surveillance phase (22.41% vs. 3.45%, P < 0.001). For surveillance patients with 1-2 polyps < 10 mm, the concordance of the "resect and discard" strategy with the guidelines improved by approximately 99.48% (95% CI: 0.989-1.000).
conclusionIn patients with 1-2 polyps ≤ 5 mm, the "resect and discard" strategy demonstrates both excellent feasibility and safety, and the follow-up period is 99.59% consistent with the guidelines. Furthermore, the scope of this strategy can be safely expanded for patients undergoing polypectomy during postresection surveillance.
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