[Oncological supervision of patients after colonoscopic polypectomy]

The high frequency of development of new adenomas in patients after colonoscopic polypectomy (30-50%) suggests the need for periodic control examinations of the whole large bowel. The diagnostic value of rectoscopy and routine diagnostic enema is limited and these methods are not suitable for periodic control of the bowel. An important method is fiberoptic sigmoidoscopy (FSS), but it is also insufficient because neoplasms are present frequently in proximal parts of the colon. The best method for evaluation of the whole colon is coloscopy, moreover, this method makes possible removal of the found polyps. In particular cases an alternative of coloscopy may be a combination of FSS and double contrast radiological examination of the colon. The frequency of control examinations of the large bowel depends primarily on the number of removed polyps. The patients after removal of a single polyp should undergo control examinations at intervals of 4-5 years. In cases with multiple adenomas removed during the first procedure or with one large adenoma (over 2 cm in diameter) should have control examinations repeated every 2-3 years.