RT Journal Article
SR Electronic
T1 Serrated polyps and polyposis of the colon: a brief review for surgeon endoscopists
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP E561
OP E566
DO 10.1503/cjs.018820
VO 64
IS 6
A1 Eric Hyun
A1 Ramzi M. Helewa
A1 Harminder Singh
A1 H. Robert Wightman
A1 Jason Park
YR 2021
UL http://canjsurg.ca/content/64/6/E561.abstract
AB Serrated polyps (SPs) were once considered benign, clinically unimportant lesions. However, it is now recognized that through the serrated neoplasia pathway (SNP), SPs play a role in the development of 15%–30% of cases of colorectal cancers (CRC). Furthermore, a high proportion of postcolonoscopy CRCs are believed to arise from SNP. Serrated polyps are classified into hyperplastic polyps, sessile serrated lesions, sessile serrated lesions with dysplasia, traditionally serrated adenomas, and unclassified serrated adenoma, each with a distinct morphological and molecular profile. Despite improved understanding, SPs remain a clinical challenge owing to evolving terminology, frequent pathologic misclassification, endoscopic underdetection, and high rates of incomplete removal. Surgeon endoscopists and surgeons who perform colorectal procedures will undoubtedly come across patients with SPs, and this paper summarizes some of the clinical challenges they will encounter. We also discuss the diagnosis and management of patients with serrated polyposis syndrome (SPS).