Published online May 21, 2020. doi: 10.3748/wjg.v26.i19.2276
Peer-review started: December 24, 2019
First decision: March 27, 2020
Revised: April 1, 2020
Accepted: April 29, 2020
Article in press: April 29, 2020
Published online: May 21, 2020
In recent years, the serrated neoplasia pathway where serrated polyps arise as a colorectal cancer has gained considerable attention as a new carcinogenic pathway. Colorectal serrated polyps are histopathologically classified into hyperplastic polyps (HPs), sessile serrated lesions, and traditional serrated adenomas; in the serrated neoplasia pathway, the latter two are considered to be premalignant. In western countries, all colorectal polyps, including serrated polyps, apart from diminutive rectosigmoid HPs are removed. However, in Asian countries, the treatment strategy for colorectal serrated polyps has remained unestablished. Therefore, in this review, we described the clinicopathological features of colorectal serrated polyps and proposed to remove HPs and sessile serrated lesions ≥ 6 mm in size, and traditional serrated adenomas of any size.
Core tip: In western countries, generally all colorectal polyps are removed, including serrated polyps, except rectosigmoid hyperplastic polyps ≤ 5 mm in size. However, no treatment strategy has been developed for colorectal serrated polyps in Asian countries. Hence, in this review, we described the clinicopathological features of colorectal serrated polyps and proposed to remove hyperplastic polyps and sessile serrated lesions ≥ 6 mm in size, and traditional serrated adenomas of any size by narrow-band imaging observation.