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Significance of Follow-up Total Colonoscopy after Resection for Colorectal Cancer
Authors:Tohru NAKAGOE  Yutaka FUKUDA  Hiroshi ISHIKAWA  Takayuki NAKAZAKI  Terumitsu SAWAI  Hidetsune IKENAGA  Hiroyuki KUSANO  Hiroyoshi AYABE  Masao TOMITA
Abstract:Abstract: This is a retrospective study of the results of total colonofiberscopy performed on 180 postoperative patients with colorectal cancer. We divided the patients into two groups: “Group A” that had no concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery and “Group B” that had a concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery, and compared them. Colorectal polyps were found in 77 patients (42.8%), recurrent cancers in 9 patients (5.0%). and metachronous cancers in 6 patients (3.3%). respectively. In Group A, no abnormality was found in 65.7% (69/ 105), which was significantly higher compared with 33.3% (25/75) of Group B (p< 0.0001). The detection ratio of polyps in Group B was significantly higher than that of Group A (61.3% versus 29.5%. p<0.0001). The number of detected polyps in Group B was also large. As for the time required to detect the polyps, no difference was found between the two groups. There was no certain tendency for the location in which the polyp developed, and polyps were found in any portion of the residual colon and rectum. The development of metachronous cancer was found in 3 patients (2.8%) in Group A and 3 patients (4.0%) in Group B, which indicated a higher ratio for Group B, but statistically no significant difference was confirmed. In the metachronous cancer group, more than half were in the early stage, and even with the advanced cancers, the diameter of the tumor was small. In all of them, a curative resection were performed, and they were found to be Dukes’A and B in which no spreading was found to the lymphnodes. From the above, we can conclude that a follow-up using total colonoscopy is useful, and that a postoperative follow-up total colonofiberscopy should be performed on postoperative patients with colorectal cancer within 6 months after surgery regardless of the presence of a concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery. Also a follow-up schedule must be conducted once a year after the first follow-up using the endoscopic method. (Dig Endosc 1994; 6: 7–16)
Keywords:colorectal cancer  follow-up total colonoscopy  metachronous cancer
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