Abstract
Total colonoscopy was performed in 700 cases in the 4-year-period from August 1983 to August 1987. Complete total colonoscopy was successful in 691 cases (98.7%). Serious complication was not encountered in our series. The rate of abnormality was 33.3 per cent, and neoplastic polyp (adenoma, early cancer), advanced cancer, ulcerative colitis and diverticulosis were the principal disorders. The histopathological study of the 184 cases of neoplastic polyp removed endoscopically revealed adenoma in 164 lesions (89.1%) and early cancer in 20 lesions (m: 15, sm: 5). The frequency of early cancer with adenoma was 75 per cent and that without adenoma was 25 per cent.
This result was consistent with the concept of adenoma-carcinoma sequence. The shape of the majority of early cancer was Is and the size 11 to 15mm. It was thought that symptoms other than anal bleeding were also important as indication of total colonoscopy for the detection of colorectal adenomas and early cancer. Therefore, we think that aggressive and vigorous total colonoscopy followed by endoscopic polypectomy are highly effective in the prevention and treatment of colorectal malignancy. And, from the viewpoint of the early diagnosis of de novo cancer, we colonoscopists should make every efforts to find not only elevated lesions but also flat and depressed lesions in the future.
