title: Synchronous and metachronous flat adenomas in colorectal cancer: single institution experience.
abstract: OBJECTIVE
  To investigate the frequency of synchronous and metachronous flat adenomas in patients with colorectal cancer, aiming at achieving early detection and excision of such lesions.
  
  
  METHODS
  From May 1999 to May 2001, 259 patients with colorectal cancer underwent initial colonoscopy for histological verification of the tumor and detection of any coexisting flat adenoma. Postoperative surveillance colonoscopy at regular intervals was carried out in all patients operated on (n=204) for detection of cancer relapse or the presence of any metachronous flat adenomas.
  
  
  RESULTS
  No patient was found with synchronous flat adenoma at the time of diagnosis of colorectal cancer. Postoperatively 7 patients developed 9 flat adenomas. Eight adenomas displayed grade II and 1 grade I-II dysplasia. Of the 9 adenomas 7 had a diameter of </= 5 mm and 2 a diameter of 8 and 10 mm.
  
  
  CONCLUSIONS
  Since flat adenomas can not be detected by routine barium enema, postoperative surveillance colonoscopy must be performed and every mucosal elevation reminiscent of early colorectal carcinoma should be treated according to standard oncological principles.
authors.affiliation: Department of Gastroenterology, Institute of Oncology and Radiology of Serbia, Beograd, Yugoslavia.
authors.forename: J
authors.initials: J
authors.lastname: Josifovski
authors.forename: D
authors.initials: D
authors.lastname: Pilcević
authors.forename: M
authors.initials: M
authors.lastname: Kocić
authors.forename: M
authors.initials: M
authors.lastname: Inić