Department of Gastroenterology, Endoscopy Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona.
Eur J Gastroenterol Hepatol. 2011 May;23(5):425-30. doi: 10.1097/MEG.0b013e3283461030.
Postpolypectomy surveillance is one of the most common reasons for performing colonoscopy. Our purpose was to assess characteristics of basal adenomas related to the recurrence of advanced adenomas, and to compare the patterns observed in recurrent adenomas with the use of conventional colonoscopy (CC) (1995-1998 period) or high-definition colonoscopy (HDC) (2005-2008 period).
Analyses were based on 612 patients with recurrent adenomas (n=306) or no adenomas (control group; n=306), with at least two follow-up colonoscopies. A total of 56 patients with recurrent adenomas during the 1995-1998 period were compared with 116 patients in the 2005-2008 period. Morphology, size, location, and pathological diagnosis of each polyp were recorded. Multiple logistic regressions were used to calculate relative risk (RR) for recurrence.
The study population was predominantly male (68.8%), with a mean age of 61.1 years and a mean follow-up period of 90.6±59.4 months. Advanced adenomas were found during follow-up evaluation in 120 patients (39.2%). The RR of advanced adenoma recurrence was 1.64 [95% confidence interval (CI): 1.01-2.64] among patients with baseline high-risk adenoma and 0.61 (CI: 0.38-0.98) among those with baseline low-risk adenoma. In the multivariable analyses, patients with larger adenomas were more likely to develop advanced recurrence (RR 1.02; 95% CI: 1.01-1.04). Both techniques (CC and HDC) detected a similar number (2.37±3.28 vs. 3.11±4.63; P=0.406) at qualifying colonoscopy. During follow-up both periods showed comparable adenoma characteristics.
Patients with larger adenomas were more likely to develop advanced recurrence. HDC did not detect significantly more adenomas than CC. Characteristics of recurrent adenomas were comparable in both periods.
息肉切除术后的随访是进行结肠镜检查的最常见原因之一。我们的目的是评估与高级别腺瘤复发相关的基底腺瘤的特征，并比较在常规结肠镜检查（CC）（1995-1998 年期间）或高清结肠镜检查（HDC）（2005-2008 年期间）中观察到的复发腺瘤的模式。
分析基于 612 例复发腺瘤患者（n=306）或无腺瘤（对照组；n=306），至少进行了两次随访结肠镜检查。将 1995-1998 年期间的 56 例复发腺瘤患者与 2005-2008 年期间的 116 例患者进行比较。记录每个息肉的形态、大小、位置和病理诊断。采用多变量逻辑回归计算复发的相对风险（RR）。
研究人群主要为男性（68.8%），平均年龄为 61.1 岁，平均随访时间为 90.6±59.4 个月。120 例患者在随访评估中发现高级别腺瘤。基线高风险腺瘤患者的高级别腺瘤复发 RR 为 1.64（95%可信区间[CI]：1.01-2.64），而基线低风险腺瘤患者的 RR 为 0.61（CI：0.38-0.98）。多变量分析中，腺瘤较大的患者更有可能发生高级别复发（RR 1.02；95%CI：1.01-1.04）。两种技术（CC 和 HDC）在 qualifying 结肠镜检查时检测到的腺瘤数量相似（2.37±3.28 与 3.11±4.63；P=0.406）。在随访期间，两个时期的腺瘤特征都具有可比性。
腺瘤较大的患者更有可能发生高级别复发。HDC 并未比 CC 检测到更多的腺瘤。两个时期的复发腺瘤特征相似。
