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Outcomes of repeat colonoscopy in patients with polyps referred for surgery without biopsy-proven cancer
Shai Friedland1, Subhas Banerjee2, Rajan Kochar2
1Department of Gastroenterology, Stanford University School of Medicine, Stanford, California, USA; VA Palo Alto Health Care System, Palo Alto, California, USA.
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.
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