title: Endoscopic management for patients with serrated polyposis syndrome is feasible and effective: a prospective observational study at a tertiary centre.
abstract: OBJECTIVE
  Serrated polyposis syndrome is a rare condition in which multiple serrated lesions develop all over the colon, which is thought to be associated with an increased risk for the development of cancer. The aim of this study was to investigate the feasibility of endoscopic treatment and standardised surveillance in patients with this increasingly recognised syndrome.
  
  
  METHODS
  From September 2010 to November 2013, consecutive patients were included in a prospective study. All patients underwent chromoendoscopy at first presentation and during surveillance. Follow-up examinations were carried out at 3 month intervals until complete clearance was achieved. Afterwards, patients entered a standardised surveillance protocol with a chromoendoscopic colonoscopy annually.
  
  
  RESULTS
  Altogether 100 colonoscopies were carried out in 28 patients, with endoscopic resection of 436 lesions. Total clearance was accomplished in 27 patients (96.0 %) after 2.5 colonoscopies (range 1 - 8). Histology revealed 359 hyperplastic polyps (82.3 %), 37 sessile serrated adenomas (8.5 %), 36 low-grade adenomas (8.3 %), and one patient with advanced colorectal cancer. Twelve patients (42.8 %) had serrated polyps > 10 mm in size. During the surveillance period, 86 additional lesions were detected and resected. The mean follow-up period was 21.5 months (range 2 - 39 months). No interval carcinoma was detected during the surveillance.
  
  
  CONCLUSIONS
  The present study indicates that endoscopic management in patients who meet the diagnostic criteria for serrated polyposis syndrome is feasible and safe. In particular, the incidence of colorectal cancer in this cohort was lower in comparison with previous studies.
authors.affiliation: Department of Internal Medicine II, HSK Wiesbaden (Teaching Hospital of the University of Mainz), Wiesbaden, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Knabe
authors.affiliation: Gastroenterologie, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Behrens
authors.affiliation: Department of Internal Medicine II, HSK Wiesbaden (Teaching Hospital of the University of Mainz), Wiesbaden, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Ell
authors.affiliation: Department of Pathology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Tannapfel
authors.affiliation: Gastroenterologie, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Pohl
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007203:Indigo Carmine; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*
chemical_list: D007203:Indigo Carmine