Performing a colonoscopy 12 months after surgery for colorectal neoplasia.
BACKGROUND
There appears to be acceptance that following up patients after surgery for colorectal neoplasia is of value. However, specific issues relating to which investigations to perform and how often remain unresolved. The aim of this project was to evaluate the clinical utility of performing a colonoscopy 12 months after curative surgery for colorectal neoplasia.


METHODS
Patients were selected if they had undergone a curative resection for colorectal neoplasia, and if they had had a completed colonoscopy prior to surgery. Study endpoints included: (i) compliance with follow up; (ii) the prevalence, total number, size, and histology of polyps; and (iii) identification of recurrent or metachronous cancer.


RESULTS
The study group included 253 patients of mean age 69.7 years (SD 11.6) and a male : female ratio of 1.4:1.0. Colonoscopies were completed on 90% of patients at a mean of 1.1 years following surgery. A total of 149 polyps were identified in 30% of patients. On histology, 42% were tubular adenomas, 6% tubulo-villous adenomas, 7% were villous adenomas, and 37% were hyperplastic. Advanced adenomas were identified in 7.9% of patients (95% CI 4.8-12.1%). No recurrent or metachronous cancers were identified.


CONCLUSIONS
We have observed a high prevalence of advanced adenomas in patients undergoing a 12-month, follow-up colonoscopy after curative surgery for colorectal neoplasia. The significance of these observations requires further evaluation.
Platell
Cameron
C
The Colorectal Surgical Unit, Fremantle Hospital and the Department of Surgery, University of Western Australia, Australia. cplatell@cyllene.uwa.edu.au
Salama
Paul
P
Barwood
Nigel
N
Makin
Gregory
G
D000236:Adenoma / Q000175:diagnosis*; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis*; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors