Surveillance of Colorectal Remnant after Surgery for Carcinoma Koichi Koizumi 1 1Department of Internal Medicine, Cancer Institue Keyword: 残存腸管 , サーベイランス , 大腸癌 , リスクファクター , rapid growing type pp.541-551
Published Date 1993/5/25
DOI https://doi.org/10.11477/mf.1403106167
  • Abstract
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 It is well known that patients having colorectal neoplasms are at high risk of developing the second neoplasms. Of 1,358 patients who underwent surgical operation in a period of 11 years from 1981 to 1991 at the Cancer Institute Hospital,489 cases (36.0%) were submitted to surveillance colonoscopy. Among them, adenoma was found in 22.5% (110/489) and carcinoma was found in 6.6% (32/489). In 32 carcinomas 10 were regarded as local recurrence or dissemination,7 were considered to be synchronous carcinoma, and 15 were judged to be metachronous carcinoma. The presence of a rapid growing type carcinoma was also suggested.

 The detection rate of new adenoma and carcinoma was 37.5% and 8.2% respectively in the cases in which adenoma was present in the initial surgery. It was 15.4% and 2.7% respectively in those without adenoma in the initial surgery. The patients having a history of colorectal carcinoma in the first degree relatives and/or extracolonic carcinoma were considered to be much higher risk of developing second neoplasms in the colorectal remnant.

 In conclusion, surveillance colonoscopy with an interval of 2 years is necessary in patients with a history of surgery for colorectal carcinoma especially in those with a history extracolonic carcinoma, and/or with a family history of colorectal carcinoma in the first degree relatives.

Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.


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