Is it time to consider prophylactic appendectomy in patients with serrated polyposis syndrome undergoing surveillance?

Assuming a cylindrical shape, it reflects 7% of the surface area of the right colon (online supplementary figure 1).1–3 However, due to its narrow calibre the appendiceal lumen cannot be evaluated. [...]the patient remains at risk for covert disease progression and ultimately interval CRC. While promising, both carry limitations.12 13 Although ESD continues to be adopted in western centres, SLA management may not be within the confines of the worldwide skillset. [...]with the demand for endoscopy easily outstripping its availability, the increase in procedural time compared with EMR reflects the impact of an ESD strategy on opportunity cost.14 Concerning EFTR, 2% of patients are referred for emergency surgery and the frequency of post-EFTR appendicitis is 9%. [...]while EFTR is an exciting advancement, at this time it should only be performed within the confines of a clearly defined research study.13 Comments SPS is the most common polyposis syndrome, with an estimated prevalence of 1 in 111 patients undergoing colonoscopy for faecal immunohistochemical test positivity.15 This is largely due to the dissemination of universal CRC screening and an increasing awareness of its diagnostic criteria.16 It represents a significant health concern, due to the increased risk of CRC, together with the economic ramifications of intensive endoscopic evaluation. [...]while universal CRC screening and minimally invasive endoscopic resection techniques have revolutionised the management of SPS, the appendix remains a challenge.