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Study examines repeat colonoscopy in patients with polyps referred for surgery without biopsy-proven cancer
Date:1/28/2014

l lesion is then removed ("resected") with a snare; the tissue is subsequently retrieved and sent to a pathologist for evaluation.

"Although multiple studies have described outcomes of patients referred to specialized interventional colonoscopy centers for polyp resection from general colonoscopy programs, less is known about the potential endoscopic resectability of large or difficult to remove polyps in patients referred for surgery directly from general colonoscopy programs," said study lead author Shai Friedland, MD, Stanford University, Palo Alto, Calif. "The aim of our study was to evaluate the outcomes after repeat colonoscopy at a tertiary care center in these patients. We found that the majority of colon polyps referred for surgery without biopsy-proven cancer can be resected endoscopically. The risks of endoscopic treatment are acceptably low. Although recurrence rates are high, these too can be successfully treated endoscopically."

Methods

This was a single center, retrospective study at Stanford University, Palo Alto, Calif. The study objective was to analyze the results of routine repeat colonoscopy in patients referred for surgical resection of colon polyps without biopsy-proven cancer. Electronic records of all patients referred to a colorectal surgery practice and an interventional colonoscopy clinic between December 2010 and March 2013 were reviewed. During this period, standard practice was to schedule all patients referred for colorectal surgery of colon polyps without biopsy-confirmed cancer for a repeat colonoscopy because the institution's colorectal surgery team believed strongly that surgical treatment of endoscopically resectable adenomas (precancerous polyps) is unnecessarily aggressive.

Colonoscopy was performed by an endoscopist with extensive experience in EMR, having performed more than 1,000 EMR procedures in the past 10 years. At the repeat colonoscopy, EMR was attempted when the lesion did not
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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