Preoperative repeat endoscopy for colorectal cancer: What is its role and when is it necessary?

Choi, Woo Jin; Cleghorn, Michelle C.; Quereshy, Fayez A.

doi:10.1503/cjs.005116

Cited by 2 publications

(2 citation statements)

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“…Colonoscopy is the gold standard for the diagnosis and surveillance of colorectal cancer, however a repeat colonoscopy either pre-operatively or intra-operatively may be required for accurate tumour localisation. 1 Repeat colonoscopy itself has an inherent risk and cost, and may be associated with a delay to definitive treatment. Common indications for it include tattooing of the lesion which was initially omitted, insufficient biopsies, incomplete colonoscopy, unclear anatomical tumour location, evaluation of a synchronous lesion or endoscopic mucosal resection (EMR).…”

Section: Introductionmentioning

confidence: 99%

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A single centre audit: repeat pre‐operative colonoscopy

Chen

Nair

Saboo

et al. 2022

ANZ Journal of Surgery

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Background: Repeat colonoscopy may be required for tumour localisation. The aim of the study is to explore the clinical settings it was used and benchmark the quality of initial colonoscopy against standardized guidelines for tumour localisation, tattooing and colonoscopy reporting amongst clinicians. Methods: A retrospective study from 2016 to 2021 has been performed on patients who underwent elective colorectal cancer resections at the Northern Hospital. Patient demographics, colonoscopic and operative details were retrieved from the Bi-National Colorectal Cancer Audit (BCCA) Registry database and hospital medical records. Primary outcomes: changes in operative approach and delays to operation. Secondary outcomes: reasons for a repeat colonoscopy and complications from repeat colonoscopy. Results: A total of 339 patients were included in this study. 94 (28.6%) underwent a repeat colonoscopy. Re-scoping rate was 29.6% for surgeons, and 26.2% for non-operating endoscopists. Surgeons had a 5.9% localisation error rate, and non-operating endoscopist 6.95% (p = 0.673). Surgeons did not have a lower rate of repeat colonoscopy (p = 0.462). Repeat endoscopy was associated with a longer time to definitive operation (p < 0.001). No complications were associated with a repeat colonoscopy. Conclusion: There was no difference in localisation error rates or repeat colonoscopy amongst surgeons (29.6%) and non-operating endoscopists (26.2%) (p = 0.462). This could be explained by the standardized endoscopy training in Australia governed by a common training board. Lack of tattooing at index colonoscopy and inadequate documentation often led to a repeat endoscopy, which was associated with a longer time to definitive operation. Standardized guidelines in tattooing of lesions and colonoscopy reporting should be implemented.

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Section: Introductionmentioning

confidence: 99%

“…Colonoscopy is the gold standard for the diagnosis and surveillance of colorectal cancer, however a repeat colonoscopy either pre‐operatively or intra‐operatively may be required for accurate tumour localisation 1 . Repeat colonoscopy itself has an inherent risk and cost, and may be associated with a delay to definitive treatment.…”

Section: Introductionmentioning

confidence: 99%