Over a 5-year period, 185 patients with a primary colorectal carcinoma were studied by colonoscopy for synchronous neoplasms. Twenty-eight patients had incomplete examinations due to obstructing tumors, and 157 had total colonoscopy. Sixty patients (35.9%) had synchronous neoplasms, of which 43 (25.7%) were adenomatous polyps, 5 (3%) were villous polyps, and 12 (7.2%) were carcinomas. The planned surgical procedure was altered on 7 of 12 synchronous cancers (58.3%), 10 of 38 adenomatous polyps, and 17 of 157 (10.8%) patients who underwent total colonoscopy. Preoperative colonoscopy is deemed essential for the optimal management of the patient with colorectal carcinoma. Cancer 53:356-359, 1984. INCE BARGEN AND RANKIN'S report in 1930,' mU1-S tiple primary colorectal neoplasms are no longer considered rare. Detection of a second simultaneously occumng primary neoplasm is of the utmost importance in the treatment of the patients with colorectal cancer.Failure to detect such a neoplasm of the lower gastrointestinal tract will inevitably result in persistent and progressive illness despite "appropriate" treatment for the obvious cancer. In the literature, the reported incidence of synchronous neoplasms varies g r e a t l~.~-~ Perhaps the major reason for this wide variation in the inaccuracy of the methods, such as barium enema, used in detecting tumors of the large b~w e l .~,~ Further, reports, based on the examination of surgical specimens, are in themselves, selective, and therefore, should be considered questionable as a method of detecting synchronous neoplasms, since no information on the status of the nonresected bowel is provided. Because nearly all previous studies of synchronous colorectal neoplasms were based on these relatively unreliable methods of examination, the Department of Colorectal Surgery, in conjunction with the En-From the Roswell Park Memorial Institute,

No abstract

No abstract

Two-hundred-forty patients with previously resected colorectal carcinoma were investigated for neoplasia of six months, 12 months and then at yearly intervals during a four-year period. Physical examination, occult blood, rigid sigmoidoscopy, barium enema and colonoscopy were used during the surveillance. Out of 304 colonoscopies, 68 were positive for neoplasia, 11 metachronous, and 17 recurrent cancers with 66 tubular adenomas and nine villous adenomas were found. Barium enema detected 38% of the lesions. Occult blood in stood was positive in 18.5%. The results of the methods of surveillance are analyzed and the relative value of each method is discussed.