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World J Clin Oncol. Apr 24, 2023; 14(4): 171-178
Published online Apr 24, 2023. doi: 10.5306/wjco.v14.i4.171
Current progress on the endoscopic features of colorectal sessile serrated lesions
Rui-Gang Wang, Lai Wei, Bo Jiang
Rui-Gang Wang, Bo Jiang, Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Lai Wei, Department of Digestive Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Author contributions: Wang RG reviewed the literature, wrote and revised the review; Wei L guided the literature search and review writing; Jiang B guided the topic selection, reviewed and suggested revisions.
Conflict-of-interest statement: All authors declare that there is no conflict-of-interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Jiang, MD, Director, Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. jba00920@btch.edu.cn
Received: February 13, 2023
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
Abstract

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.

Keywords: Colorectal cancer; Sessile serrated lesions; Endoscopic features

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.