[Endoscopic monitoring after polypectomy. What efficacy? What rhythm?].
IN THE ABSENCE OF ENDOSCOPIC MONITORING: The risk of colorectal cancer is higher than in the general population in patients presenting an adenoma with a diameter of more than 1 cm, and/or comprising villous structures and/or severe dysplasia. The risk is not increased in the presence of one or two tubular adenomas measuring less than 1 cm and without severe dysplasia. It has been demonstrated that endoscopic monitoring decreases the incidence and mortality of colorectal cancers in these patients. MONITORING MODALITIES: A control colonoscopy, 3 years after polypectomy is sufficient in most cases. Colonoscopy is recommended within the 3 months following exeresis of a transformed sessile adenoma, in order to check that the polypectomy was complete. A control colonoscopy can be performed 1 year later in the rare cases presenting more than 3 adenomas, with one measuring more than 1 cm. When the control colonoscopy is normal, one can wait at least five years before conducting a further control.
Faivre
J
J
Registre des cancers digestifs (INSERM CR1 96-05, Registre associé INSERM-InVS), Faculté de Médecine-BP 87900, F21079 Dijon. jean.faivre@u-bourgogne.fr
Benhamiche
A M
AM
Dancourt
V
V
D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013997:Time Factors