Carolin Krause1, W Kruis2. 1. Department of Gastroenterology, Evangelisches Krankenhaus Kalk, University of Cologne, Cologne, Germany. carolin.krause@evkk.de. 2. Department of Gastroenterology, Evangelisches Krankenhaus Kalk, University of Cologne, Cologne, Germany.
Abstract
BACKGROUND AND PURPOSE: Guidelines recommend perioperative complete colonoscopy in patients with colorectal cancer (CRC) to reduce the risk of metachronous carcinoma. Our aim was to verify these recommendations by examining the residual colon of patients with incomplete preoperative colonoscopy. PATIENTS AND METHODS: This retrospective analysis included patients with the initial diagnosis of CRC and preoperative incomplete or no colonoscopy. Postoperative colonoscopies were investigated to identify synchronous lesions. RESULTS: In two-thirds of the patients, synchronous lesions could be detected. In 78% of the cases, the lesion was located proximal of the endpoint of the initial colonoscopy and therefore undiscovered. Two-thirds of the synchronous lesions were adenomata. CONCLUSIONS: Complete perioperative colonoscopy in patients with CRC should be performed to reduce the rate of metachronous carcinoma. Postoperative completion of preoperative insufficiently colonoscoped patients is recommended.
BACKGROUND AND PURPOSE: Guidelines recommend perioperative complete colonoscopy in patients with colorectal cancer (CRC) to reduce the risk of metachronous carcinoma. Our aim was to verify these recommendations by examining the residual colon of patients with incomplete preoperative colonoscopy. PATIENTS AND METHODS: This retrospective analysis included patients with the initial diagnosis of CRC and preoperative incomplete or no colonoscopy. Postoperative colonoscopies were investigated to identify synchronous lesions. RESULTS: In two-thirds of the patients, synchronous lesions could be detected. In 78% of the cases, the lesion was located proximal of the endpoint of the initial colonoscopy and therefore undiscovered. Two-thirds of the synchronous lesions were adenomata. CONCLUSIONS: Complete perioperative colonoscopy in patients with CRC should be performed to reduce the rate of metachronous carcinoma. Postoperative completion of preoperative insufficiently colonoscoped patients is recommended.
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