Shai Friedland1, Subhas Banerjee2, Rajan Kochar2, Ann Chen2, Andrew Shelton3. 1. Department of Gastroenterology, Stanford University School of Medicine, Stanford, California, USA; VA Palo Alto Health Care System, Palo Alto, California, USA. 2. Department of Gastroenterology, Stanford University School of Medicine, Stanford, California, USA. 3. Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.
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. Published by Mosby, Inc.
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. Published by Mosby, Inc.
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