Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Int J Colorectal Dis. 2013 Jun;28(6):835-40. doi: 10.1007/s00384-012-1613-5. Epub 2012 Nov 21.
Surveillance colonoscopy is undertaken after resection of colorectal cancer to detect and treat local recurrence and metachronous lesions, with the aim of improving survival. This study aimed to clarify the current timing of surveillance colonoscopies and evaluate the rates of local recurrence and metachronous tumors.
We retrospectively analyzed data from 459 patients who underwent surveillance colonoscopy at our institution after curative resection of colorectal cancer. The number and timing of surveillance colonoscopies, incidence of local recurrence and metachronous lesions, pathological findings of lesions, treatment of lesions, and outcomes were recorded.
The first surveillance colonoscopy was undertaken at 6-18 months after surgery in 73 % of patients. Local recurrence was detected in three cases (0.7 %), all during the first surveillance colonoscopy, which was performed >1 year after surgery. These three patients all underwent additional surgery and were alive 5 years later. Invasive metachronous cancers were detected in six patients (1.3 %) at 18-57 months after surgery, and advanced adenomas were detected in 30 patients.
Considering the low incidence of postoperative lesions and the timing of lesion detection, reducing the number of surveillance colonoscopies after surgery for colorectal cancer may be appropriate.
结直肠癌切除术后进行监测性结肠镜检查，以检测和治疗局部复发和异时性病变，从而提高生存率。本研究旨在明确当前监测性结肠镜检查的时间，并评估局部复发和异时性肿瘤的发生率。
我们回顾性分析了在我院接受结直肠癌根治术后进行监测性结肠镜检查的 459 例患者的数据。记录了监测性结肠镜检查的次数和时间、局部复发和异时性病变的发生率、病变的病理发现、病变的治疗和结局。
73%的患者在术后 6-18 个月进行了第一次监测性结肠镜检查。3 例（0.7%）在第一次监测性结肠镜检查时发现局部复发，均在术后 1 年以上进行。这 3 例患者均接受了额外的手术，5 年后仍存活。6 例（1.3%）患者在术后 18-57 个月时发现侵袭性异时性癌症，30 例患者发现高级别腺瘤。
考虑到术后病变的发生率和病变检测的时间，减少结直肠癌手术后的监测性结肠镜检查次数可能是合适的。
