Residual or recurrent adenoma after piecemeal resection of a polyp 20 mm or larger is common, and most of it is small and treatable at the first check. The first surveillance colonoscopy is therefore part of the treatment, not an optional extra.
Arrange the first scar check at about 6 months after piecemeal resection, with a second at about 18 months if clear. Inspect the scar with high-definition white light and chromoendoscopy or virtual chromoendoscopy, biopsy anything suspicious, and treat residual tissue at the same procedure.
- First scar check about 6 months after piecemeal resection of a ≥20 mm polyp
- Second check about 18 months after the first if clear
- Photograph and tattoo the site at the index procedure
- Treat residual adenoma at the surveillance procedure
Why it matters
Recurrence found at the first scar check is usually small and treatable endoscopically; left unchecked it can grow.
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