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A Second Look at ColonoscopyIndications, Failures, and Costs
Jerome S. Abrams, MD
Arch Surg. 1982;117(7):913-917.
Abstract
• Results of colonoscopy and colonoscopic polypectomy in 599 patients have been reviewed. Added experience has not decreased the number of failures—failure to examine the entire colon, polyps not retrieved for histological examination ("lost polyps"), undetected ("missed") lesions, and false-negative biopsy specimens. The incidence of invasive carcinoma in polyps measuring under 1 cm is less than 1%; polypectomy should be reserved for larger lesions or demonstrated growth of small polyps. Diagnostic colonoscopy in selected patients (those with persistent gross or occult rectal bleeding but normal results from sigmoidoscopic and barium enema studies) demonstrates a causative lesion in greater than 25% and detects a cancer in 5% to 10% of patients.
(Arch Surg 1982;117:913-917.
Author Affiliations
From the Department of Surgery, College of Medicine, University of Vermont, Burlington.
Footnotes
Accepted for publication Sept 30, 1981.
Read before the annual meeting of the New England Surgical Society, Portsmouth, NH, Sept 26, 1980.
Reprint requests to Department of Surgery, College of Medicine, University of Vermont, Burlington, VT 05405 (Dr Abrams).
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