title: Colonoscopic Polypectomies and Recommendations on the Colonoscopy Follow-up Intervals Depending on Endoscopic and Histopathological Findings.
abstract: OBJECTIVE
  To show histopathological diagnoses after colonoscopic polypectomy in the University Hospital Center (KBC) Split with recommendations on further follow-up colonoscopy depending on the endoscopic and histological findings.
  
  
  METHODS
  The study included 2842 patients who underwent colonoscopy in a two-year period (2008-2009), followed by a detailed analysis of 350 patients in which one or more polyps were simultaneously removed and 163 patients who were only sampled for histological analysis. Patients from the National Program for Colorectal Cancer Prevention and patients in which colonoscopy is indicated as part of daily outpatient or inpatient treatment were included as well.
  
  
  RESULTS
  During 2008 and 2009 in KBC Split, out of a total of 2842 colonoscopies, 350 patients underwent colonoscopic polypectomy, whereby 618 polyps were removed (1-8 polyps in individual patients), while in 163 patients only biopsy specimens were sampled. Out of the total of 557 polyps sent for histological analysis, 236 were hyperplastic (42%), 193 were identified as tubular adenoma (35%), 84 were tubulovillous (15%), 18 villous (3%), 9 were adenocarcinoma (2%) and other 17 (3%). In 35 (15.4%) polyps high-grade dysplasia was found. The largest number of nonpolypectomized changes confirmed the presence of adenocarcinoma (76-47%), adenomas and hyperplastic polyps were 37 (22%) and regular findings 23 (14%). Mucosal high-grade dysplasia was demonstrated in 35 (23.1%) biopsied changes.
  
  
  CONCLUSIONS
  Colonoscopies with polypectomy decreased the risk of the formation of colorectal cancer in these patients almost to the level of risk in patients who have not even had a polyp during colonoscopy. Arguably the best method of prevention and early detection of colorectal cancer are already widely established national programs. The next qualitative level is constantly improving the quality of colonoscopy with clear criteria and the establishment of a body to evaluate the performers and the equipment, and making recommendations on the colonoscopy follow-up intervals depending on endoscopic and histopathological findings of patients who for any reason underwent colonoscopy.
authors.affiliation: Department of Internal Medicine, University Hospital Center Split, Split, Croatia.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Simunic
authors.forename: Nikola
authors.initials: N
authors.lastname: Perkovic
authors.forename: Bruna
authors.initials: B
authors.lastname: Rosic-Despalatovic
authors.forename: Ante
authors.initials: A
authors.lastname: Tonkic
authors.forename: Zarko
authors.initials: Z
authors.lastname: Ardalic
authors.forename: Marina
authors.initials: M
authors.lastname: Titlic
authors.forename: Marina
authors.initials: M
authors.lastname: Maras-Simunic
keywords: colonoscopic polipectomy; quality of endoscopy.; surveillance