Review for 10.1186/s12876-020-01499-2 (2020)

Reviewer’s report
Title: 
Long Term Outcomes of Colon Polyps with High Grade Dysplasia Following Endoscopic
Resection
Version: 
0 
Date: 
04 Aug 2020
Reviewer's report:
This retrospective cohort study tried to find the cumulative incidence rate of recurrent advanced neoplasia
in patients with high-grade dysplasia (HGD) in colon polyps after endoscopic resection at index
endoscopy.
Previous studies have addressed this goal with contrasting results. In the current study, the rates of
metachronous adenoma and advanced adenoma after resection for colon polyps with HGD is 58% and
20% respectively. Moreover, the number of adenomas ≥3 and male gender, have been shown to increase
the risk of recurrent advanced adenoma.
I have some comments:
- Endoscopic examinations were performed from 1998 to 2007, and some of the variables could be
changed in the meantime (different instruments, different endoscopists…). Could this have influenced the
final results? 
- Many factors, such as bowel cleasing, the use of high definition colonoscopes, the withdrawal time,
endoscopist year of training, might influence the adenoma detection rate. Did the authors evaluated these
aspects?
- How the endoscopic follow-up protocol was schedulated after the index colonoscopy?
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Is the study design appropriate to answer the research question (including the use of appropriate controls),
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