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Goran Carlsson, MD, PhD; Nicholas J. Petrelli, MD; Hector Nava, MD; Lemuel Herrera, MD; Arnold Mittelman, MD

Arch Surg. 1987;122(11):1261-1263.

Abstract
• Between 1975 and 1984, 270 patients underwent a potentially curative resection for colorectal carcinoma. One hundred eighty-eight patients (70%) underwent preoperative colonoscopy, of which 129 patients (69%) were followed up with at least two postoperative colonoscopies. In 91 patients (70%), preoperative colonoscopy revealed no synchronous adenomatous polyps or cancer. Synchronous adenomatous polyps were found in 35 patients (27%), and three patients (2.3%) had a synchronous invasive cancer. Nineteen (54%) of the 35 patients with synchronous adenomatous polyps developed metachronous adenomatous polyps during the follow-up period compared with 24 (26%) of 91 patients without synchronous adenomatous polyps. The median interval to the development of metachronous adenomatous polyps was 19 months, and all of these polyps were 1 cm or less in size. Patients with synchronous adenomatous polyps less than 30 cm from the primary lesion (68%) developed metachronous polyps more often than did patients whose synchronous adenomatous polyps were more than 30 cm from the primary lesion (37%). Preoperative colonoscopy is important for determining synchronous pathology and identifying patients at risk for metachronous polyps.

(Arch Surg 1987;122:1261-1263)

Author Affiliations
From the Department of Surgical Oncology, Roswell Park Memorial Institute, Buffalo.

Footnotes
Accepted for publication July 9, 1987.

Read before the Annual Meeting of the Society of Surgical Oncology, London, April 29, 1987.

Reprint requests to Department of Surgical Oncology, Roswell Park Memorial Institute, 666 Elm St, Buffalo, NY 14263 (Dr Petrelli).

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