Detection of Polyps After Resection of Colorectal Cancer

Abstract

PurposeBecause colonoscopy after colorectal cancer surgery is important for detecting synchronous or metachronous colorectal neoplasms, we designed this study to investigate, by using postoperative colonoscopy, the miss rate for and the location of polyps remaining after colorectal cancer surgery.MethodsIn a prospectively-collected patient database, 264 patients were shown to have undergone a colorectal cancer resection between May 2012 and June 2013. Of these, 116 who had received a complete colonoscopy preoperatively and postoperatively were included in this study.ResultsOf these 116 patients, 68 were males and 48 were females; their mean age was 63 years. The mean time after surgery at which postoperative colonoscopy was performed was 7.1 months (range, 3-15 months). On postoperative colonoscopy, a total of 125 polyps were detected. Of these, there were no cancerous lesions; 46 (36.8%) were neoplastic polyps, and 79 (63.2%) were nonneoplastic polyps. Fifty-nine polyps (47.2%) and 15 polyps (12%) were located in the proximal and the distal parts of the anastomosis, respectively. The miss rates for the total numbers of polyps and of neoplastic polyps remaining after surgery were 37.4% and 24.2%, respectively. The incidence of neoplastic polyps increased during postoperative colonoscopy as it had during preoperative colonoscopy (r = 0.164, P = 0.048).ConclusionColonoscopic surveillance after colorectal cancer resection results in the detection of pathologic polyps in one-fourth of the cases. During postoperative colonoscopy, careful examination of the proximal colon is necessary. Patients in whom multiple neoplastic polyps had been detected during preoperative colonoscopy require careful and thorough follow-up.

Resting heart rate is an independent predictor of advanced colorectal adenoma recurrence

“…In our study, surveillance colonoscopy after treatment of CRC revealed an adenoma recurrence rate of 32.3% and an advanced adenoma recurrence rate of 9.0%, which are similar to the results of previous studies showing an adenoma recurrence rate of 34.4–41.4% and an advanced adenoma recurrence rate of 4.4–6.5% [ 25 – 27 ]. With regard to the heart rate, multivariate analysis showed that an increased resting heart rate was associated with a significantly greater risk of advanced adenoma recurrence, but not with tubular adenoma and overall polyps.…”

The Effects of Physical Activity and Body Fat Mass on Colorectal Polyp Recurrence in Patients with Previous Colorectal Cancer

“…These are strong points of our study, which enable us to show a more significant difference in adenoma recurrence by intervention. In our study, surveillance colonoscopy after treatment of colorectal cancer found an adenoma recurrence rate of 32.3% and advanced adenoma recurrence rate of 9.0%, which are similar to the results of previous studies showing an adenoma recurrence rate of 34.4% to 41.4% and advanced adenoma recurrence rate of 4.4% to 6.5% (38)(39)(40). Concerning exercise, our study showed that advanced adenoma recurred in 14.4% of the sedentary group, significantly greater than 6.4% of the active exercise group.…”

Evaluation of the results of colonoscopy in patients who received positive fecal occult blood test (FOBT) for colorectal cancer screening

“…The conversion of adenomatous polyps to neoplasia resulting from irregular epithelial proliferation and inability to show complete maturation or differentiation is a process commonly studied and commonly known as adenoma-carci-noma sequence. [16,17] Screening and polyp excision significantly reduced colon cancer incidence and mortality. [18,19] According to the results of a study conducted by Högberg et al [20] Fecal immunochemical tests successfully detect 90% of samptomatic colon cancers and adenomatous polyps.…”