[Colonoscopic surveillance of patients operated on in colorectal cancer. Retrospective evaluation of 269 tests in 125 patients].
The ideal frequency of endoscopic surveillance of patients operated on for colorectal cancer is not known. We report our experience of colonoscopic follow up of 125 patients after excision of a colorectal cancer. The median interval between resection and the first check colonoscopy was 12 months. The median duration of follow-up was 28 months (range: 3 months to 10 years). 269 colonoscopies allowed diagnosis of 8 anastomotic recurrences within a median delay of 21 months after surgery (range: 3 months to 5 years). In 6 of these patients, the recurrence was clinically suspected. In 2 patients, it was asymptomatic and was discovered on systematic colonoscopy. Potentially curative surgery was only possible in 1 case. Follow up colonoscopies also allowed excision of 113 adenomatous polyps in 39 patients and the discovery of 4 new invasive cancers within a median delay of 7.4 years after excision of the first cancer. Due to the disappointing value of colonoscopy in the detection of anastomotic recurrences and the propensity of the remaining colon to develop new polyps, in the absence of a comparative trial, we arbitrarily adopted a follow up rhythm based on early post-operative colonoscopy (3 months post-surgery) and then yearly for the first 2 years. Further follow-up was similar to that adopted for patients with a past history of endoscopic polypectomy.
Aubert
A
A
Service d'Hépato-Gastro-Entérologie, Hôpital Broussais, Paris.
Bloch
F
F
Camilleri
J P
JP
Bouillot
J L
JL
Alexandre
J H
JH
Petite
J P
JP
D000368:Aged; D003082:Colectomy; D003111:Colonic Polyps / Q000175:diagnosis; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D012189:Retrospective Studies
Surveillance coloscopique des patients opérés d'un cancer colorectal. Bilan rétrospectif de 269 examens chez 125 patients.