From the Research
After removal of a serrated polyp adenoma, normal colonic mucosa typically regenerates at the site, with some degree of submucosal fibrosis possible but not predominant, as supported by the most recent and highest quality study 1. The healing process involves re-epithelialization where normal colonic epithelial cells migrate and proliferate to cover the defect created by the polypectomy. Initially, there may be some inflammatory changes and granulation tissue formation, but over time (usually within 2-4 weeks), complete mucosal healing occurs with restoration of normal colonic tissue architecture. Key factors influencing the healing process include the size of the polyp, the method of removal, and the individual's overall health. Endoscopists often note these healed polypectomy sites as subtle, flat, pale scars during follow-up colonoscopies, as described in studies focusing on the management and surveillance of serrated polyps 2, 3. It's essential to consider the potential for recurrence and the development of new polyps, particularly in individuals with a history of serrated polyps or other risk factors for colorectal cancer, highlighting the importance of surveillance and follow-up care 4, 5. The body's remarkable regenerative capacity allows for restoration of normal mucosal structure and function in most cases, which is crucial for maintaining the integrity of the colonic lining and its absorptive and barrier functions. In clinical practice, prioritizing the most recent and highest quality evidence, such as the study published in 2024 1, is vital for guiding management decisions and optimizing patient outcomes in terms of morbidity, mortality, and quality of life. Therefore, when considering the tissue type seen after removal of a serrated polyp adenoma, normal colonic mucosa regeneration is the expected outcome, with fibrosis being a less common finding, as supported by the latest research in the field 1.