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Importance of Early Follow-up Colonoscopy in Patients at High Risk for Colorectal Polyps

대한대장항문학회지 2013년 29권 6호 p.243 ~ 247
 ( Jung Sung-Taek ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer

 ( Sohn Dae-Kyung ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
 ( Hong Chang-Won ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
 ( Kim Byung-Chang ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
 ( Park Ji-Won ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
 ( Han Kyung-Su ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
 ( Chang Hee-Jin ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
 ( Choi Hyo-Sung ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
 ( Oh Jae-Hwan ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer

Abstract


Purpose: Minimizing the polyp miss rate during colonoscopy is important for patients at high risk for colorectal polyps. We investigated the polyp miss rate and the factors associated with it in high-risk patients.

Methods: The medical records of 163 patients who underwent follow-up colonoscopy between January 2001 and April 2010, which was within 9 months after a polypectomy, because the index colonoscopy had shown multiple (more than 3) adenomas or advanced adenoma were retrospectively reviewed. Miss rates were calculated for all polyps, for neoplastic polyps and for advanced adenomas. Factors associated with the miss rates in these patients, such as the location, shape and size of the polyp, were analyzed.

Results: The miss rates for polyps, adenomas, adenomas <5 mm, adenomas ≥5 mm and advanced adenomas were 32.6%, 20.9%, 17.7%, 3.2%, and 0.9%, respectively. No carcinoma, except for one small carcinoid tumor, was missed. Flat shape and small size (<5 mm) were significantly associated with adenoma miss rate. The miss rate was significantly higher for flat-type advanced adenomas than for protruded-type advanced adenomas (27.7% vs 4.1%).

Conclusion: The polyp miss rate in patients at high risk for colorectal polyps was higher than expected. Efforts are needed to reduce miss rates and improve the quality of colonoscopy. Also, early follow-up colonoscopy is mandatory, especially in patients at high risk.

키워드

Colonoscopy; Miss rate; Colorectal neoplasms; Metachronous adenoma
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