Outcomes of repeat colonoscopy in patients with polyps referred for surgery without biopsy-proven cancer

Gastrointest Endosc. 2014 Jan;79(1):101-7. doi: 10.1016/j.gie.2013.06.034. Epub 2013 Jul 31.

Abstract

Background: Despite advances in endoscopic treatment, many colonic adenomas are still referred for surgical resection. There is a paucity of data on the suitability of these lesions for endoscopic treatment.

Objective: To analyze the results of routine repeat colonoscopy in patients referred for surgical resection of colon polyps without biopsy-proven cancer.

Design: Retrospective review.

Setting: University hospital.

Patients: Patients referred to a colorectal surgeon for surgical resection of a polyp without biopsy-proven cancer.

Interventions: Repeat colonoscopy.

Main outcome measurements: The rate of successful endoscopic treatment.

Results: There were 38 lesions in 36 patients; 71% of the lesions were noncancerous and were successfully treated endoscopically. In 26% of the lesions, previous removal was attempted by the referring physician but was unsuccessful. The adenoma recurrence rate was 50%, but all recurrences were treated endoscopically and none were cancerous. Two patients were admitted for overnight observation. There were no major adverse events.

Limitations: Single center, retrospective.

Conclusions: In the absence of biopsy-proven invasive cancer, it is appropriate to reevaluate patients referred for surgical resection by repeat colonoscopy at an expert center.

Keywords: APC; ESD; HGD; argon plasma coagulation; endoscopic submucosal dissection; high-grade dysplasia.

MeSH terms

  • Adenoma, Villous / pathology*
  • Adenoma, Villous / surgery
  • Aged
  • Biopsy
  • Colon / pathology*
  • Colonic Neoplasms / pathology*
  • Colonic Neoplasms / surgery
  • Colonic Polyps / pathology*
  • Colonic Polyps / surgery
  • Colonoscopy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Rectal Neoplasms / pathology*
  • Rectal Neoplasms / surgery
  • Referral and Consultation*
  • Reoperation
  • Retrospective Studies
  • Tertiary Care Centers
  • Treatment Outcome