Abstract
In a series of 144 patients after surgery for colorectal cancer, we conducted surveillance colonoscopy to investigate the incidence of neoplastic lesions in the remaining colon and attempted to design the effective program for the surveillance. High risk group included males aged 50 to 69, patients having adenomas of the colon at surgery, and those with family history of adenocarcinoma. The detection rate of neoplasmas was higher in case of left-sided colon cancers than the right-sided without significant differene. Most cases detected within 2 years after the operation belonged to the high risk group. All four local recurrences of rectal cancers were found within 2 years after the operation.
We recommend the following program. The first colonoscopy must be done at sixth month after surgery, when total colon was not exmined thoroughly. In high risk group and/or patients who had low anterior resection, colonoscopy should be performed at the psotoperative first and a scond year. Low risk group patients may have the first colonoscopy at second year after the operation. Thereafter every patient must be examined at fourth and sixth year. And fecal occult blood test should be performed every six months up to six years. Beyond six years, high risk patients must have colonscopy at eighth and tenth year, and low risk patients, at tenth year. Fecal occult blood test is recommended every one year. From tenth year on, all patients are directed to have screening of colorectal cancer.
