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Postoperative follow-up of patients with colorectal carcinoma by colonoscopy
1Department of Diagnostic Radiology, Huddinge University Hospital, Sweden.
Objective:
To find out if colonoscopy is of use in the follow-up of patients who have been operated on for colorectal carcinoma.
Design:
Retrospective study.
Setting:
Department of diagnostic radiology, university hospital.
Subjects:
390 consecutive patients operated on for colorectal carcinoma during the 10-year period 1981 to 1990.
Main Outcome Measures:
Number of recurrences, synchronous of metachronous tumours, and number and size of adenomas found on colonoscopy.
Results:
Neoplastic lesions were found in 175 (45%) of the 390 patients studied. There were 14 anastomotic recurrences and 12 new primary carcinomas. At operation for recurrent tumours Dukes' A or B lesions were found in half of the 14 patients who had no symptoms, and a quarter of the 12 who had had symptoms. Those with recurrent carcinoma were younger than those without. Adenomas 1 cm in diameter or more were found in 44 patients and 104 had adenomas less than 1 cm. In addition one carcinoid was found.
Conclusion:
Colonoscopy gave a high yield of neoplastic lesions when used to follow-up patients after resection of colorectal carcinoma, particularly at six months, and resulted in half the recurrent carcinomas being diagnosed before the patients had symptoms. We recommend its use for follow-up of high risk patients, but further studies are needed to establish the optimum time intervals.
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