Published online Apr 24, 2023. doi: 10.5306/wjco.v14.i4.171
Peer-review started: February 13, 2023
First decision: March 28, 2023
Revised: April 6, 2023
Accepted: April 13, 2023
Article in press: April 13, 2023
Published online: April 24, 2023
Processing time: 66 Days and 14.5 Hours
Along with the discovery and refinement of serrated pathways, the World Health Organization amended the classification of digestive system tumors in 2019, recommending the renaming of sessile serrated adenomas/polyps to sessile serrated lesions (SSLs). Given the particularity of the endoscopic appearance of SSLs, it could easily be overlooked and missed in colonoscopy screening, which is crucial for the occurrence of interval colorectal cancer. Existing literature has found that adequate bowel preparation, reasonable withdrawal time, and awareness of colorectal SSLs have improved the quality and accuracy of detection. More particularly, with the continuous advancement and development of endoscopy technology, equipment, and accessories, a potent auxiliary tool is provided for accurate observation and immediate diagnosis of SSLs. High-definition white light endoscopy, chromoendoscopy, and magnifying endoscopy have distinct roles in the detection of colorectal SSLs and are valuable in identifying the size, shape, character, risk degree, and potential malignant tendency. This article delves into the relevant factors influencing the detection rate of colorectal SSLs, reviews its characteristics under various endoscopic techniques, and expects to attract the attention of colonoscopists.
Core Tip: Because of its unique endoscopic patterns and behavior, sessile serrated lesions (SSLs) are easily missing during colonoscopy. SSL is a critical cause of interval colorectal cancer, so it is necessary to summarize the endoscopic features of the sessile serrated lesion to help endoscopists make a better identification and diagnosis.