Abstract
We evaluated the significance of follow-up study in the patients after endoscopic polypectomy. The incidence of adenomas which were detected again during follow-up period was 25.8% for them with single adenoma and 52% of the patient with multiple adenoma at the initial examination. Adenomas which were found by initial examination were commonly distributed in the rectum and sigmoid colon, on the other hand newly detected adenoma were frequently located in the right side colon including the transverse colon. Two of 209 patients (0.9%) were early colonic cancer after endoscopic polypectomy. Eighty three percent of newly detected adenomas were found within first two years after initial polypectomy. The data suggested that there were high incidence of newly developed adenomas including missing ones in patients with adenomas. In addition, if we defined the redetected adenoma as missing cases within one year, its incidence was 6.9%. We recommended follow-up intervals as follows : Patients with early colonic cancer should be examined 6 months after the initial polypectomy, and then every year. Patients with multiple colonic adenomas at the initial colonoscopy should be followed-up annually, while those initially presenting with a single adenoma should be followed-up every two years. After "clean colon" was confirmed, we recommended the follow-up interval to be every 2 or 3 years in all patients. It is concluded that the follow-up colonoscopy for patients with the previous polypectomy is valuable for the early detection and prevention of colon cancer.
