Colonoscopic surveillance after treatment of colorectal polyps or cancer
Patients with a history of a colorectal adenoma or an invasive cancer are at increased risk for metachronous colorectal neoplasia. After the colonoscopic or surgical resection of an adenoma or cancer, most patients enter a colonoscopy surveillance program to monitor for potentially missed synchronous lesions and for the subsequent occurrence of metachronous colorectal neoplasms. In a small subset of patients, continued colonoscopic surveillance may not be appropriate because of advanced age and/or serious comorbid medical problems. In this article, we will review the role of postpolypectomy colonoscopy surveillance after colonoscopic removal of benign and malignant colorectal adenomas and after surgical resection of invasive colorectal cancer. We will also recommend general surveillance guidelines for effective colonoscopic follow-up in these patients. (C) 2000 by W.B. Saunders Company.