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Synchronous pathologic findings in patients with colorectal cancer and preoperative incomplete colonoscopy

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Abstract

Background and purpose

Guidelines recommend perioperative complete colonoscopy in patients with colorectal cancer (CRC) to reduce the risk of metachronous carcinoma. Our aim was to verify these recommendations by examining the residual colon of patients with incomplete preoperative colonoscopy.

Patients and methods

This retrospective analysis included patients with the initial diagnosis of CRC and preoperative incomplete or no colonoscopy. Postoperative colonoscopies were investigated to identify synchronous lesions.

Results

In two-thirds of the patients, synchronous lesions could be detected. In 78% of the cases, the lesion was located proximal of the endpoint of the initial colonoscopy and therefore undiscovered. Two-thirds of the synchronous lesions were adenomata.

Conclusions

Complete perioperative colonoscopy in patients with CRC should be performed to reduce the rate of metachronous carcinoma. Postoperative completion of preoperative insufficiently colonoscoped patients is recommended.

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Acknowledgments

The authors thank Miriam Hobrücker, Evangelisches Krankenhaus Kalk, Cologne, for providing all patient data. They also thank Dietmar Krause, MD, Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, for reading and revising the manuscript.

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Authors and Affiliations

  1. Department of Gastroenterology, Evangelisches Krankenhaus Kalk, University of Cologne, Cologne, Germany

    Carolin Krause & W. Kruis

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  1. Carolin Krause
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  2. W. Kruis
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Correspondence to Carolin Krause.

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Krause, C., Kruis, W. Synchronous pathologic findings in patients with colorectal cancer and preoperative incomplete colonoscopy. Int J Colorectal Dis 34, 1407–1412 (2019). https://doi.org/10.1007/s00384-019-03330-1

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