BACKGROUND AND AIMS Serrated polyposis syndrome (SPS) increases colorectal cancer risk. We describe the numbers of colonoscopies and polypectomies performed to achieve and maintain low polyp burdens, and the feasibility of expanding surveillance intervals in patients who achieve endoscopic control. METHODS We retrospectively evaluated a prospectively collected database on 115 patients with SPS undergoing surveillance at Indiana University Hospital between June 2005 and May 2018. The endoscopist provided surveillance interval recommendations based on polyp burden. Endoscopic control was considered successful if surveillance examinations exhibited fewer polyps and if no or only an occasional polyp ≥1 cm in size was present at follow-up. Initial control was designated as the clearing phase and the maintenance phase was surveillance after control was established. RESULTS In total, 87 patients (75.7%) achieved endoscopic control, with some others currently in the clearing phase. Achieving control required a mean of 2.84 colonoscopies (including the baseline) over 20.4 months and a mean total of 27.9 polyp resections. After establishing control, 71 patients were recommended to receive ≥24-month follow-up. Of those, 60 patients (69.0% of patients with initial control) continued surveillance at our center. The mean interval between colonoscopies during maintenance was 19.3 months with 6.74 mean polypectomies per procedure on polyps primarily <1 cm. There were no incident cancers or colon surgeries during maintenance. CONCLUSION Most patients achieved control of polyp burden with 2 to 3 colonoscopies over 1 to 2 years. After reaching control, 60 patients returned at intervals up to 24 months with no incident cancers and no surgeries required. Expansion of surveillance intervals to 24 months is effective and safe for many patients with SPS who reach control of polyp burden.

中文翻译：

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内窥镜控制锯齿状息肉病综合征的息肉负担和监视间隔的扩大。

背景和目的锯齿状息肉病综合征（SPS）增加了结直肠癌的风险。我们描述了为实现和维持低息肉负担而进行的结肠镜检查和多视野检查的次数，以及扩大实现内窥镜控制的患者的监护间隔的可行性。方法我们回顾性评估了前瞻性收集的数据库，该数据库收集了2005年6月至2018年5月在印第安纳大学医院接受监测的115例SPS患者的内镜。内镜医师根据息肉负担提供了监测间隔建议。如果监测检查显示息肉较少，并且随访时无息肉或息肉≥1cm，则认为内窥镜控制是成功的。建立控制后，最初的控制被指定为清理阶段，维护阶段是监视。结果共有87例患者（75.7％）实现了内窥镜控制，其他一些患者目前处于清理阶段。要实现控制，需要在20.4个月内平均进行2.84例结肠镜检查（包括基线），平均进行27.9例息肉切除术。建立对照后，建议71例患者接受≥24个月的随访。在这些患者中，有60名患者（占初始控制患者的69.0％）在我们中心继续进行监视。维持期间结肠镜检查之间的平均间隔为19.3个月，对于主要<1 cm的息肉，每个手术平均有6.74个多视镜检查。维护期间无意外癌症或结肠手术。结论大多数患者在1至2年内通过2至3次结肠镜检查实现了息肉负担的控制。达到控制水平后，有60名患者每隔24个月返回一次，没有发生任何癌症，也不需要手术。对于许多能够控制息肉负担的SPS患者，将监视间隔延长至24个月是有效且安全的。