《Table 5 Recommendation of interval before repeat colonoscopy》

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《Risk factors for local recurrence and appropriate surveillance interval after endoscopic resection》

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The identification of piecemeal resection as an independent risk factor for the recurrence of colorectal tumors led us to investigate the periods from the endoscopic resection to recurrence.Interestingly，the period to recurrence in cases resected into more than 5 pieces was much shorter than that in those resected into less than 4 pieces（3.8±1.9 mo vs 7.9±5.0 mo，P<0.05）.Thus，colorectal tumors endoscopically resected into more than 5 pieces bear a very high risk of recurrence within 3 mo post-resection while those resected into less than 4 pieces bear a high risk for recurrence within 8mo.Consistent with these data，previous reports[11，14]provide the evidence that the recurrence rate is higher and the interval to recurrence tends to be shorter for colorectal tumors resected into more than 5 pieces.Our analysis of the periods from the initial endoscopic treatment to tumor recurrence prompts us to propose appropriate intervals for endoscopic surveillance.Because the period to recurrence in cases resected into 1 piece with unclear margin（incomplete margin）was 6.1±4.5months in this study，surveillance endoscopy needed to be performed within 1 to 3mo after the resection.In addition，surveillance endoscopy needed to be performedwithin 1 to 3 mo in cases resected into more than 5 pieces，and within 4 to 6 mo in cases resected into less than 4 pieces.Based on these，we strongly suggest that not only the piecemeal resection procedure but also the number of the resected pieces increase the risk of colorectal tumor recurrence（Table 4）.In Table 5，we provide our recommendation for the interval preceding repeat colonoscopy.