Objective: to determine whether the features of adenomas identified in a fi
rst endoscopic examination may predict the presence of polyps with advanced
pathological features that may have gone unnoticed and whether early colon
oscopy, may benefit these patients.
Material and methods: we examined 133 patients with diagnosis of colonic ad
enomas who had undergone complete colonoscopy and endoscopic polypectomy. A
ll of them underwent colonoscopic, follow-up at 3 years. Seventy nine patie
nts underwent colonoscopic follow-up both at 6 months and at 3 years, while
54 patients underwent just colonoscopic follow-up at 3 years and 47 just a
t 6 months.
Results: fifteen per cent of the patients analyzed developed polyps with pa
thological features after 6 months. The size and histological analysis of t
he polyps detected in the initial colonoscopic examination did not affect t
hese results (p <0.05). The number of polyps was statistically significant:
patients with 3 or more polyps in the initial colonoscopic examination pre
sented more polyps with pathological features after six months (25.8 versus
5,8%, p=0002). This follow-up examination at 3 years did not reveal a high
er occurrence of polyps with pathological features in any of the two groups
of patients, namely, those who had undergone early colonoscopy and those w
ho had not.
Conclusions: patients with multiple polyps have greater probability of deve
loping synchronous. polyps with some pathological features which may have g
one unnoticed. Since early examination has not shown to provide a benefit f
or these patients, the first follow-up colonoscopy should be performed at 3
years, particularly if the initial colonoscopy is negative.