The value of one year post-operative colonoscopy in the surveillance of cancer of the colon and rectum

Abstract EN

Intensive follow-up of cancer of the colon and rectum includes colonoscopy 1 year after curative resection and is the current practice in Calgary.

There is much debate in the literature as to the value of this intensive follow-up, including 2 prospective randomized controlled trials show¬ing no benefit.

The purpose of this study was to assess the benefit of 1-year follow-up colonoscopy by documenting the findings at the time of the procedure.

One hundred and four (104) charts were randomly selected and reviewed.

All had undergone peri-operative colonoscopy, resection for curative intent and follow-up colonoscopy approximately 1 year post-op.

There were 16 (15%) abnormal findings at the time of follow-up colonoscopy.

In 10, the colon had not been “cleared” peri-operatively and the polyps identified were anticipated and removed.

In 6 (6 %) there were new findings not previously documented : 3 hyperplasic polyps ; 2 small (< 0.75cm) adenomatous polyps and 1 anastigmatic recurrence of a rectal cancer.

The recurrent cancer was within reach of a rigid sigmoid scope and the polyps can be considered not clinically significant.

This review of our experience with surveillance colonoscopy 1 year after cura¬tive resection for cancer of the colon and rectum supports the previously published data from 2 randomized controlled trials showing no benefit.