BACKGROUND: This study aimed to determine the diagnostic yield of colonoscopy 1 year after colorectal cancer (CRC) resection based on whether the index colonoscopy was performed by the operating surgeon. METHODS: All patients undergoing surgery for colorectal cancer by two colon and rectal surgeons at a university hospital from 1991 to 2005 were identified from the tumor registry. Those patients with a complete preoperative colonoscopy by any physician and a 1-year follow-up examination by the operating surgeon were selected for the study population. Family history of colorectal cancer, tumor location, endoscopist, presence of synchronous neoplasms, and findings of 1-year colonoscopy were recorded. Fisher's exact test was used to compare the probability of finding any adenoma, advanced adenoma, or invasive cancer based on the index endoscopist. RESULTS: Of the 719 patients who underwent resection during the study period, 432 met the inclusion criteria. The index colonoscopy for 117 of these patients (27.1%) was performed by one of the two surgeons. Overall, 10 patients (2.3%) had a "new" cancer diagnosed at 1 year, and 1 patient (0.2%) had a local recurrence. Patients whose index colonoscopy was performed by their operating surgeon appeared less likely to have an advanced lesion found at 1 year (5.1% vs 11.4%; p = 0.06). The index colonoscopy for 9 of the 10 of cancers found at 1 year was not performed by the operating surgeon. CONCLUSIONS: Colonoscopy 1 year after CRC resection is clearly justified. An index colonoscopy by the operating surgeon eliminates a "handoff" and may diminish the incidence of high-risk lesions at 1 year.
BACKGROUND: This study aimed to determine the diagnostic yield of colonoscopy 1 year after colorectal cancer (CRC) resection based on whether the index colonoscopy was performed by the operating surgeon. METHODS: All patients undergoing surgery for colorectal cancer by two colon and rectal surgeons at a university hospital from 1991 to 2005 were identified from the tumor registry. Those patients with a complete preoperative colonoscopy by any physician and a 1-year follow-up examination by the operating surgeon were selected for the study population. Family history of colorectal cancer, tumor location, endoscopist, presence of synchronous neoplasms, and findings of 1-year colonoscopy were recorded. Fisher's exact test was used to compare the probability of finding any adenoma, advanced adenoma, or invasive cancer based on the index endoscopist. RESULTS: Of the 719 patients who underwent resection during the study period, 432 met the inclusion criteria. The index colonoscopy for 117 of these patients (27.1%) was performed by one of the two surgeons. Overall, 10 patients (2.3%) had a "new" cancer diagnosed at 1 year, and 1 patient (0.2%) had a local recurrence. Patients whose index colonoscopy was performed by their operating surgeon appeared less likely to have an advanced lesion found at 1 year (5.1% vs 11.4%; p = 0.06). The index colonoscopy for 9 of the 10 of cancers found at 1 year was not performed by the operating surgeon. CONCLUSIONS: Colonoscopy 1 year after CRC resection is clearly justified. An index colonoscopy by the operating surgeon eliminates a "handoff" and may diminish the incidence of high-risk lesions at 1 year.
Authors: Robert J Green; Joshua P Metlay; Kathleen Propert; Paul J Catalano; John S Macdonald; Robert J Mayer; Daniel G Haller Journal: Ann Intern Med Date: 2002-02-19 Impact factor: 25.391
Authors: Douglas K Rex; Charles J Kahi; Bernard Levin; Robert A Smith; John H Bond; Durado Brooks; Randall W Burt; Tim Byers; Robert H Fletcher; Neil Hyman; David Johnson; Lynne Kirk; David A Lieberman; Theodore R Levin; Michael J O'Brien; Clifford Simmang; Alan G Thorson; Sidney J Winawer Journal: Gastroenterology Date: 2006-05 Impact factor: 22.682
Authors: Nancy N Baxter; Meredith A Goldwasser; Lawrence F Paszat; Refik Saskin; David R Urbach; Linda Rabeneck Journal: Ann Intern Med Date: 2008-12-15 Impact factor: 25.391
Authors: R L Cali; R M Pitsch; A G Thorson; P Watson; P Tapia; G J Blatchford; M A Christensen Journal: Dis Colon Rectum Date: 1993-04 Impact factor: 4.585
Authors: S J Winawer; A G Zauber; M N Ho; M J O'Brien; L S Gottlieb; S S Sternberg; J D Waye; M Schapiro; J H Bond; J F Panish Journal: N Engl J Med Date: 1993-12-30 Impact factor: 91.245