Skip to main content
Erschienen in: Gastro-News 4/2019

05.08.2019 | Koloskopie | zertifizierte fortbildung

Vorsorgekoloskopie, Polypektomie, Kontrolluntersuchungen

Management und Nachsorgeintervalle kolorektaler Polypen

verfasst von: PD Dr. med. Christian Pox

Erschienen in: Gastro-News | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die meisten kolorektalen Karzinome entstehen aus Adenomen, in etwa 30 % uber die serratierte Karzinogenese mit serratierten Adenomen als Ausgangsläsion. Risikofaktoren für die Karzinomentwicklung sind Anzahl und Größe der Adenome, villöse Histologie und hochgradige Neoplasie. Auch wenn sich aus der Mehrzahl der Adenome nie ein Karzinom entwickeln wird, muss zur effektiven Senkung des Karzinomrisikos das Ziel einer Koloskopie dennoch ein polypenfreier Darm sein. Dass nach einer Polypektomie generell ein erhöhtes Zweitneoplasierisiko besteht, ist die Rationale einer strukturierten Nachsorge nach Abtragung von Adenomen.
Literatur
1.
Zurück zum Zitat Institut RK. Krebs in Deutschland 2013/2014. 11. Ausgabe ed. Berlin 2017. Institut RK. Krebs in Deutschland 2013/2014. 11. Ausgabe ed. Berlin 2017.
2.
Zurück zum Zitat Pox CP, Altenhofen L, Brenner H, Theilmeier A, Von Stillfried D, Schmiegel W. Efficacy of a nationwide screening colonoscopy program for colorectal cancer. Gastroenterology 2012;142:1460–7 e2CrossRef Pox CP, Altenhofen L, Brenner H, Theilmeier A, Von Stillfried D, Schmiegel W. Efficacy of a nationwide screening colonoscopy program for colorectal cancer. Gastroenterology 2012;142:1460–7 e2CrossRef
3.
Zurück zum Zitat Brenner H, Altenhofen L, Kretschmann J, Rosch T, Pox C, Stock C, et al. Trends in Adenoma Detection Rates During the First 10 Years of the German Screening Colonoscopy Program. Gastroenterology. 2015;149:356–66 e1CrossRef Brenner H, Altenhofen L, Kretschmann J, Rosch T, Pox C, Stock C, et al. Trends in Adenoma Detection Rates During the First 10 Years of the German Screening Colonoscopy Program. Gastroenterology. 2015;149:356–66 e1CrossRef
4.
Zurück zum Zitat Turner KO, Genta RM, Sonnenberg A. Lesions of All Types Exist in Colon Polyps of All Sizes. Am J Gastroenterol 2018;113:303–6CrossRef Turner KO, Genta RM, Sonnenberg A. Lesions of All Types Exist in Colon Polyps of All Sizes. Am J Gastroenterol 2018;113:303–6CrossRef
5.
Zurück zum Zitat Brenner H, Hoffmeister M, Stegmaier C, Brenner G, Altenhofen L, Haug Uv. Risk of progression of advanced adenomas to colorectal cancer by age and sex: estimates based on 840,149 screening colonoscopies. Gut 2007;56:1585–9CrossRef Brenner H, Hoffmeister M, Stegmaier C, Brenner G, Altenhofen L, Haug Uv. Risk of progression of advanced adenomas to colorectal cancer by age and sex: estimates based on 840,149 screening colonoscopies. Gut 2007;56:1585–9CrossRef
6.
Zurück zum Zitat Schmiegel W, Buchberger B, Follmann M, Graeven U, Heinemann V, Langer T, et al. S3-Leitlinie Kolorektales Karzinom. Z Gastroenterol A comparison of the resection rate for cold and hot snare polypectomy for 4-9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study). Gut 2018;67:1950–72017;55:1344–498 Schmiegel W, Buchberger B, Follmann M, Graeven U, Heinemann V, Langer T, et al. S3-Leitlinie Kolorektales Karzinom. Z Gastroenterol A comparison of the resection rate for cold and hot snare polypectomy for 4-9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study). Gut 2018;67:1950–72017;55:1344–498
7.
Zurück zum Zitat Burgess NG, Hourigan LF, Zanati SA, Brown GJ, Singh R, Williams SJ, et al. Risk Stratification for Covert Invasive Cancer Among Patients Referred for Colonic Endoscopic Mucosal Resection: A Large Multicenter Cohort. Gastroenterology 2017;153:732–42 e1CrossRef Burgess NG, Hourigan LF, Zanati SA, Brown GJ, Singh R, Williams SJ, et al. Risk Stratification for Covert Invasive Cancer Among Patients Referred for Colonic Endoscopic Mucosal Resection: A Large Multicenter Cohort. Gastroenterology 2017;153:732–42 e1CrossRef
8.
Zurück zum Zitat Lee CK, Shim JJ, Jang JY. Cold snare polypectomy vs. Cold forceps polypectomy using double-biopsy technique for removal of diminutive colorectal polyps: a prospective randomized study. Am J Gastroenterol 2013;108:1593–600CrossRef Lee CK, Shim JJ, Jang JY. Cold snare polypectomy vs. Cold forceps polypectomy using double-biopsy technique for removal of diminutive colorectal polyps: a prospective randomized study. Am J Gastroenterol 2013;108:1593–600CrossRef
9.
Zurück zum Zitat Ferlitsch M, Moss A, Hassan C, Bhandari P, Dumonceau JM, Paspatis G, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017;49:270–97CrossRef Ferlitsch M, Moss A, Hassan C, Bhandari P, Dumonceau JM, Paspatis G, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017;49:270–97CrossRef
10.
Zurück zum Zitat Kawamura T, Takeuchi Y, Asai S, Yokota I, Akamine E, Kato M, et al. A comparison of the resection rate for cold and hot snare polypectomy for 4-9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study). Gut 2018;67:1950–7CrossRef Kawamura T, Takeuchi Y, Asai S, Yokota I, Akamine E, Kato M, et al. A comparison of the resection rate for cold and hot snare polypectomy for 4-9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study). Gut 2018;67:1950–7CrossRef
11.
Zurück zum Zitat Dwyer JP, Tan JYC, Urquhart P, Secomb R, Bunn C, Reynolds J, et al. A prospective comparison of cold snare polypectomy using traditional or dedicated cold snares for the resection of small sessile colorectal polyps. Endosc Int Open 2017;5:E1062–E8CrossRef Dwyer JP, Tan JYC, Urquhart P, Secomb R, Bunn C, Reynolds J, et al. A prospective comparison of cold snare polypectomy using traditional or dedicated cold snares for the resection of small sessile colorectal polyps. Endosc Int Open 2017;5:E1062–E8CrossRef
12.
Zurück zum Zitat Hassan C, Repici A, Sharma P, Correale L, Zullo A, Bretthauer M, et al. Efficacy and safety of endoscopic resection of large colorectal polyps: a systematic review and meta-analysis. Gut 2016;65:806–20CrossRef Hassan C, Repici A, Sharma P, Correale L, Zullo A, Bretthauer M, et al. Efficacy and safety of endoscopic resection of large colorectal polyps: a systematic review and meta-analysis. Gut 2016;65:806–20CrossRef
13.
Zurück zum Zitat Yang D, Othman M, Draganov PV. Endoscopic Mucosal Resection vs Endoscopic Submucosal Dissection For Barrett’s Esophagus and Colorectal Neoplasia. Clin Gastroenterol Hepatol 2019;17:1019–28CrossRef Yang D, Othman M, Draganov PV. Endoscopic Mucosal Resection vs Endoscopic Submucosal Dissection For Barrett’s Esophagus and Colorectal Neoplasia. Clin Gastroenterol Hepatol 2019;17:1019–28CrossRef
14.
Zurück zum Zitat Klein A, Tate DJ, Jayasekeran V, Hourigan L, Singh R, Brown G, et al. Thermal Ablation of Mucosal Defect Margins Reduces Adenoma Recurrence After Colonic Endoscopic Mucosal Resection. Gastroenterology 2019;156:604–13 e3CrossRef Klein A, Tate DJ, Jayasekeran V, Hourigan L, Singh R, Brown G, et al. Thermal Ablation of Mucosal Defect Margins Reduces Adenoma Recurrence After Colonic Endoscopic Mucosal Resection. Gastroenterology 2019;156:604–13 e3CrossRef
15.
Zurück zum Zitat Probst A, Schneider A, Schaller T, Anthuber M, Ebigbo A, Messmann H. Endoscopic submucosal dissection for early gastric cancer: are expanded resection criteria safe for Western patients? Endoscopy 2017;49:855–65CrossRef Probst A, Schneider A, Schaller T, Anthuber M, Ebigbo A, Messmann H. Endoscopic submucosal dissection for early gastric cancer: are expanded resection criteria safe for Western patients? Endoscopy 2017;49:855–65CrossRef
16.
Zurück zum Zitat Schmidt A, Beyna T, Schumacher B, Meining A, Richter-Schrag HJ, Messmann H, et al. Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications. Gut 2018;67:1280–9CrossRef Schmidt A, Beyna T, Schumacher B, Meining A, Richter-Schrag HJ, Messmann H, et al. Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications. Gut 2018;67:1280–9CrossRef
17.
Zurück zum Zitat Lin D, Soetikno RM, McQuaid K, Pham C, Doan G, Mou S, et al. Risk factors for postpolypectomy bleeding in patients receiving anticoagulation or antiplatelet medications. Gastrointest Endosc 2018;87:1106–13CrossRef Lin D, Soetikno RM, McQuaid K, Pham C, Doan G, Mou S, et al. Risk factors for postpolypectomy bleeding in patients receiving anticoagulation or antiplatelet medications. Gastrointest Endosc 2018;87:1106–13CrossRef
18.
Zurück zum Zitat Denzer U, Beilenhoff U, Eickhoff A, Faiss S, Huttl P, In der Smitten S, et al. [S2k guideline: quality requirements for gastrointestinal endoscopy, AWMF registry no. 021-022] Z Gastroenterol. 2015;53:E1–227CrossRef Denzer U, Beilenhoff U, Eickhoff A, Faiss S, Huttl P, In der Smitten S, et al. [S2k guideline: quality requirements for gastrointestinal endoscopy, AWMF registry no. 021-022] Z Gastroenterol. 2015;53:E1–227CrossRef
19.
Zurück zum Zitat Rees CJ, Rajasekhar PT, Wilson A, Close H, Rutter MD, Saunders BP, et al. Narrow band imaging optical diagnosis of small colorectal polyps in routine clinical practice: the Detect Inspect Characterise Resect and Discard 2 (DISCARD 2) study. Gut 2017;66:887–95CrossRef Rees CJ, Rajasekhar PT, Wilson A, Close H, Rutter MD, Saunders BP, et al. Narrow band imaging optical diagnosis of small colorectal polyps in routine clinical practice: the Detect Inspect Characterise Resect and Discard 2 (DISCARD 2) study. Gut 2017;66:887–95CrossRef
20.
Zurück zum Zitat Choi JY, Jung SA, Shim KN, Cho WY, Keum B, Byeon JS, et al. Meta-analysis of predictive clinicopathologic factors for lymph node metastasis in patients with early colorectal carcinoma. J Korean Med Sci 2015;30:398–406PubMedPubMedCentral Choi JY, Jung SA, Shim KN, Cho WY, Keum B, Byeon JS, et al. Meta-analysis of predictive clinicopathologic factors for lymph node metastasis in patients with early colorectal carcinoma. J Korean Med Sci 2015;30:398–406PubMedPubMedCentral
21.
Zurück zum Zitat Lieberman DA, Holub J, Eisen G, Kraemer D, Morris CD. Utilization of colonoscopy in the United States: results from a national consortium. Gastrointest Endosc 2005;62:875–83CrossRef Lieberman DA, Holub J, Eisen G, Kraemer D, Morris CD. Utilization of colonoscopy in the United States: results from a national consortium. Gastrointest Endosc 2005;62:875–83CrossRef
22.
Zurück zum Zitat Gavin DR, Valori RM, Anderson JT, Donnelly MT, Williams JG, Swarbrick ET. The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK. Gut 2013;62:242–9CrossRef Gavin DR, Valori RM, Anderson JT, Donnelly MT, Williams JG, Swarbrick ET. The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK. Gut 2013;62:242–9CrossRef
23.
Zurück zum Zitat Martinez ME, Baron JA, Lieberman DA, Schatzkin A, Lanza E, Winawer SJ, et al. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology 2009;136:832–41CrossRef Martinez ME, Baron JA, Lieberman DA, Schatzkin A, Lanza E, Winawer SJ, et al. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology 2009;136:832–41CrossRef
24.
Zurück zum Zitat Robertson DJ, Lieberman DA, Winawer SJ, Ahnen DJ, Baron JA, Schatzkin A, et al. Colorectal cancers soon after colonoscopy: a pooled multicohort analysis. Gut 2014;63:949–56CrossRef Robertson DJ, Lieberman DA, Winawer SJ, Ahnen DJ, Baron JA, Schatzkin A, et al. Colorectal cancers soon after colonoscopy: a pooled multicohort analysis. Gut 2014;63:949–56CrossRef
25.
Zurück zum Zitat Atkin WS, Morson BC, Cuzick J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med 1992;326:658–62CrossRef Atkin WS, Morson BC, Cuzick J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med 1992;326:658–62CrossRef
26.
Zurück zum Zitat Cottet V, Jooste V, Fournel I, Bouvier AM, Faivre J, Bonithon-Kopp C. Long-term risk of colorectal cancer after adenoma removal: a population-based cohort study. Gut 2012;61:1180–6CrossRef Cottet V, Jooste V, Fournel I, Bouvier AM, Faivre J, Bonithon-Kopp C. Long-term risk of colorectal cancer after adenoma removal: a population-based cohort study. Gut 2012;61:1180–6CrossRef
27.
Zurück zum Zitat Loberg M, Kalager M, Holme O, Hoff G, Adami HO, Bretthauer M. Long-term colorectal-cancer mortality after adenoma removal. N Engl J Med 2014;371:799–807CrossRef Loberg M, Kalager M, Holme O, Hoff G, Adami HO, Bretthauer M. Long-term colorectal-cancer mortality after adenoma removal. N Engl J Med 2014;371:799–807CrossRef
28.
Zurück zum Zitat Chetty R. Traditional serrated adenoma (TSA): morphological questions, queries and quandaries J Clin Pathol. 2016;69:6–11CrossRef Chetty R. Traditional serrated adenoma (TSA): morphological questions, queries and quandaries J Clin Pathol. 2016;69:6–11CrossRef
29.
Zurück zum Zitat Erichsen R, Baron JA, Hamilton-Dutoit SJ, Snover DC, Torlakovic EE, Pedersen L, et al. Increased Risk of Colorectal Cancer Development Among Patients With Serrated Polyps. Gastroenterology 2016;150:895–902 e5CrossRef Erichsen R, Baron JA, Hamilton-Dutoit SJ, Snover DC, Torlakovic EE, Pedersen L, et al. Increased Risk of Colorectal Cancer Development Among Patients With Serrated Polyps. Gastroenterology 2016;150:895–902 e5CrossRef
30.
Zurück zum Zitat Schreiner MA, Weiss DG, Lieberman DA. Proximal and large hyperplastic and nondysplastic serrated polyps detected by colonoscopy are associated with neoplasia. Gastroenterology 2010;139:1497–502CrossRef Schreiner MA, Weiss DG, Lieberman DA. Proximal and large hyperplastic and nondysplastic serrated polyps detected by colonoscopy are associated with neoplasia. Gastroenterology 2010;139:1497–502CrossRef
31.
Zurück zum Zitat Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2012;143:844–57CrossRef Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2012;143:844–57CrossRef
32.
Zurück zum Zitat Anderson JC, Baron JA, Ahnen DJ, Barry EL, Bostick RM, Burke CA, et al. Factors Associated With Shorter Colonoscopy Surveillance Intervals for Patients With Low-Risk Colorectal Adenomas and Effects on Outcome. Gastroenterology 2017;152:1933–43 e5CrossRef Anderson JC, Baron JA, Ahnen DJ, Barry EL, Bostick RM, Burke CA, et al. Factors Associated With Shorter Colonoscopy Surveillance Intervals for Patients With Low-Risk Colorectal Adenomas and Effects on Outcome. Gastroenterology 2017;152:1933–43 e5CrossRef
33.
Zurück zum Zitat Winawer SJ, Zauber AG, O’Brien MJ, Ho MN, Gottlieb L, Sternberg SS, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med 1993;328:901–6CrossRef Winawer SJ, Zauber AG, O’Brien MJ, Ho MN, Gottlieb L, Sternberg SS, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med 1993;328:901–6CrossRef
34.
Zurück zum Zitat Pohl H, Srivastava A, Bensen SP, Anderson P, Rothstein RI, Gordon SR, et al. Incomplete polyp resection during colonoscopy-results of the complete adenoma resection (CARE) study. Gastroenterology 2013;144:74–80 e1CrossRef Pohl H, Srivastava A, Bensen SP, Anderson P, Rothstein RI, Gordon SR, et al. Incomplete polyp resection during colonoscopy-results of the complete adenoma resection (CARE) study. Gastroenterology 2013;144:74–80 e1CrossRef
Metadaten
Titel
Vorsorgekoloskopie, Polypektomie, Kontrolluntersuchungen
Management und Nachsorgeintervalle kolorektaler Polypen
verfasst von
PD Dr. med. Christian Pox
Publikationsdatum
05.08.2019
Verlag
Springer Medizin
Schlagwort
Koloskopie
Erschienen in
Gastro-News / Ausgabe 4/2019
Print ISSN: 1869-1005
Elektronische ISSN: 2520-8667
DOI
https://doi.org/10.1007/s15036-019-0485-8

Weitere Artikel der Ausgabe 4/2019

Gastro-News 4/2019 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.