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colonoscopy ; polypectomy ; adenoma ; large intestine ; recurrence
Abstract:
In certain patients despite of the removal of all adenomas new lesions appear. Additionally there is a group of patients at a greater risk of developing new polyps. The aim of this study was to analyse recurrence rate of new adenomas in surveillance colonoscopy in patients after polypectomy. A group of 184 patients who underwent endoscopic polypectomy and surveillance colonoscopy were involved in the analysis. Histopathological features of primarily removed adenomas as well as recurrent polyps were evaluated. Further aspect of the study was the identification of risk factors that may have led to increased recurrence rate of adenomas. The most common pathomorphological type of removed adenomas was tubular with medium grade dysplasia. Average size of polyps was 9,6 mm. Primary lesions were mostly found in the sigmoid and rectum. Reappearance of new colorectal polyps was 38%. In the majority of cases recurrent adenomas were smaller (6,1mm) than the initial ones. Most of them were of tubular type with low-grade dysplasia. They were more commonly seen in the proximal parts of the colon. Male gender, smoking, statins, removal of more than one polyp, initial lesions in the proximal colon, size over 10mm, high-grade dysplasia or advanced adenoma seemed to influence the risk of recurrence. In our opinion patients with the before mentioned characteristics are at increased risk of polyp r ; ecurrence.
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Rembiasz, Kazimierz ; Matłok, Maciej