Endoscopy 2019; 51(04): S211
DOI: 10.1055/s-0039-1681798
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Colon and rectum ePosters
Georg Thieme Verlag KG Stuttgart · New York

FACTORS OF PREOPERATIVE COLONOSCOPY THAT AFFECT THE DETECTION OF SYNCHRONOUS ADENOMA IN COLORECTAL CANCER PATIENTS

JH Park
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea, Republic of
,
HS Moon
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea, Republic of
,
JS Kim
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea, Republic of
,
SH Kang
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea, Republic of
,
JK Sung
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea, Republic of
,
HY Jeong
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 
 

    Aims:

    Despite thorough preoperative screening, approximately 19 – 30% of synchronous polyps are detected after colon cancer surgery. Remnant synchronous lesions might require additional colonoscopy procedure or surgery. The purpose of this study was to investigate the factors of preoperative colonoscopy that can affect the detection of synchronous lesions in the colon in patients who have undergone surgery for colorectal cancer.

    Methods:

    From January 1, 2012 to December 31, 2016, we retrospectively analyzed 1147 colorectal cancer patients, who underwent colectomy and colonoscopy. In all, 518 patients underwent colonoscopy before and after surgery. Index colonoscopy was defined as the last endoscopy performed before surgery. Follow up colonoscopy was performed one year after surgery. The effects of bowel preparation, index colonoscopy, adenoma, and physician and patient factors on postoperative PMR, AMR and AAMR were analyzed. An Aronchick scale "Excellent" or "good" was defined as optimal bowel preparation.

    Results:

    The overall rate of missed adenomas was 25.7% (95% confidence interval, 22.2 – 29.8%). On comparing the optimal and non-optimal groups, the post-operative PMR, AMR (11% vs. 49%, and 5.9% vs. 35.2%, p < 0.01), AAMR (3.0% vs. 4.6%, p = 0.272), and size of the polyps (3.2 ± 0.55 vs. 4.9 ± 0.23 mm, p = 0.017) were higher in the non-optimal bowel preparation group. Based on the optimal group, we found more number of synchronous adenomas in the fair group (OR 5.72) and poor group (OR 11.39). On univariate analysis, the patients' age and withdrawal time (p < 0.01) also influenced AMR. Physicians with more than 10 years' experience in colonoscopy had lower post-operative ADR than those with less experience, but there was no statistically significant difference. Multivariate analysis showed that age and preoperative bowel preparation influenced postoperative AMR.

    Conclusions:

    Higher age of the patient and non-optimal bowel preparation at index colonoscopy, have a negative effect on lowering the postoperative AMR.


    #