Serrated polyposis is common and often missed

The edition in brief

Serrated polyposis: a US Multi-Society Task Force review and consensus statement describes serrated polyposis syndrome as the most common polyposis syndrome and frequently unrecognised. Diagnosis rests on WHO criteria counting the size, cumulative lifetime number and location of serrated polyps. Patients have higher risk of prevalent and incident colorectal cancer and need meticulous inspection, clearing of the colon and frequent surveillance, with surgery for cancer or unmanageable polyp burden. There is no common germline variant, so genetic testing is only for those meeting criteria for a known syndrome; first-degree relatives need colonoscopic screening. Remimazolam: an ASGE clinical practice update gives its first recommendations on the ultra-short-acting benzodiazepine for endoscopic sedation, positioning it as an alternative to midazolam and propofol, particularly in high-risk patients. Enhanced recovery in IBD: 18 studies, mostly observational, found ERAS pathways shortened stay after colorectal surgery for IBD by about 1.6 days without more readmissions, reoperations or complications. AI at gastroscopy: in a secondary analysis of a trial with about 26,000 patients, lesions flagged high-risk by an AI system were far more likely to be biopsied and to yield neoplasia, and false alarms did not drive indiscriminate biopsy.