Validity of early colonoscopy for the treatment of adenomas missed by initial endoscopic examination

Citation
C. Cordero et al., Validity of early colonoscopy for the treatment of adenomas missed by initial endoscopic examination, REV ESP E D, 93(8), 2001, pp. 524-528
Citations number
33
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS
ISSN journal
1130-0108 → ACNP
Volume
93
Issue
8
Year of publication
2001
Pages
524 - 528
Database
ISI
SICI code
1130-0108(200108)93:8<524:VOECFT>2.0.ZU;2-8
Abstract
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.