Abstract
In order to determine the feasibility, yield, and impact of routine total colonoscopy on the management of large-bowel cancer 157 cancer patients underwent 175 colonoscopic procedures; 13.6 per cent of the cancers had been missed on double-contrast barium enema examination.
Among 92 patients undergoing perioperative colonoscopy, the lesion was reached in 89 per cent and the cecum in 60 per cent; 7.6 per cent demonstrated synchronous cancers, all curable, and all missed on barium-enema examination.
Seventy-eight patients underwent colonoscopy at an average of 3.7 years after treatment of the index cancer; 7.7 per cent demonstrated metachronous cancers, all curable, two-thirds of which were missed on barium-enema examination.
Benign polyps were noted in 62 per cent of the patients studied; 77 per cent of those polyps, 1 cm or greater in size, were missed on barium-enema examination. Polyps were found proximal to the cancer in 60 per cent of the patients with polyps. Approximately 85 per cent of those with multiple cancers demonstrated benign polyps. Preoperative total colonoscopy with periodic postoperative colonoscopy at an interval of three to five years are essential in the reliable detection of synchronous cancers and for the detection of metachronous cancers at an earlier, more favorable stage.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Czerny. II. Aus der Heidelberger chirurgischen Klinik: Nachtrag zur Darmresection. Berl Klin Wochenschr 1880;17:683–4.
Lasser A. Synchronous primary adenocarcinoma of the colon and rectum. Dis Colon Rectum 1978;21:20–2.
Copeland EM, Jones RS, Miller LD. Multiple colon neoplasms: prognostic and therapeutic implications. Arch Surg 1969;98:141–3.
Heald RJ, Lockhart-Mummery HE. The lesion of the second cancer of the large bowel. Br. J. Surg 1972;59:16–9.
Coller JA, Corman ML, Veidenheimer MC. Colonic polypoid disease: need for total colonoscopy. Am J Surg 1976;131:490–5.
Penfold JC, Renney JT. Early detection of colonic cancer by colonoscopy (symposium). Dis Colon Rectum 1977;20:85–8.
Appel MF. Preoperative and postoperative colonoscopy for colorectal carcinoma. Dis Colon Rectum 1976;19:664–6.
Heald RJ, Bussey HJ. Clinical experiences at St. Mark's Hospital with multiple synchronous cancers of the colon and rectum. Dis Colon Rectum 1975;18:6010.
Theuerkauf FJ Jr. Colonoscopy and polypectomy. Am Surg 1976;42:33–43.
Kirsner JB, Rider JA, Moeller HC, Palmer WL, Gold SS. Polyps of the colon and rectum: statistical analysis of a long term follow-up study. Gastroenterology 1960;39:178–82.
Williams CB, Hunt RH, Loose H, Riddell RH, Sakai Y, Swarbrick ET. Colonoscopy in the management of colon polyps. Br J Surg 1974;61:673–82.
Muto T, Bussey HJ, Morson BC. The evolution of cancer of the colon and rectum. Cancer 1975;36:2251–70.
Welin S. Results of the Malmö technique of colon examination. JAMA 1967;199:369–71.
Theuerkauf FJ Jr. Rectal and colonic polyp relationships via colonoscopy and fibersigmoidoscopy. Dis Colon Rectum 1978;21:2–7.
Spratt JS Jr, Ackerman LV, Moyer CA. Relationship, of polyps of the colon to colonic cancer. Ann Surg 1958;148:682–98.
Lockhart-Mummery HE, Heald RJ. Metachronous cancer of the large intestine. Dis Colon Rectum 1972;15:261–4.
Wolff WI, Shinya H, Geffen A, Ozoktay S, DeBeer R. Comparison of colonoscopy and the contrast enema in five hundred patients with colorectal disease. Am J Surg 1975;129:181–6.
Author information
Authors and Affiliations
Additional information
Read at the Meeting of the American Society of Colon and Rectal Surgeons, Atlanta, Georgia, June 10 to 14, 1979. This article received the Purdue Frederick Award for best paper authored by a resident.
About this article
Cite this article
Reilly, J.C., Rusin, L.C. & Theuerkauf, F.J. Colonoscopy: Its role in cancer of the colon and rectum. Dis Colon Rectum 25, 532–538 (1982). https://doi.org/10.1007/BF02564161
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF02564161