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conferenceseries
.com
Volume 7, Issue 5 (Suppl)
J Gastrointest Dig Syst, an open access journal
ISSN:2161-069X
Gastroenterology 2017
November 13-14, 2017
November 13-14, 2017 | Las Vegas, USA
13
th
International Conference on
Clinical Gastroenterology, Hepatology and Endoscopy
Colonoscopy surveillance after colorectal carcinoma: Determining the optimal interval for follow-up
Winesh Ramphal
Amphia Hospital Breda, The Netherlands
Introduction:
Patients who underwent curative surgery for colorectal (CRC) cancer are at risk for developing metachronous
colorectal tumours or anastomotic recurrence. The aim of this study is to determine the incidence of recurrent colorectal cancer
found in a colonoscopy surveillance program.
Methods:
This single centre retrospective observational cohort study includes patients that underwent curative surgery for CRC
between 2005 and 2015. All reports of postoperative colonoscopies were retrieved to calculate incidence rates of recurrence or
metachronous CRC. Survival analysis were performed to estimate survival between endoscopic surveillance and no surveillance.
Results:
Of 2420 patients, 1644 (67.9%) underwent at least one postoperative colonoscopy and 776 (32.1%) did not. In 1087 patients,
colonoscopy was performed in the first 18 months after surgery, detecting 34 (3.1%) metachronous colorectal tumours or anastomotic
recurrences. Thirty-three other patients were also diagnosed with recurrent colorectal cancer, but these tumours were found by other
diagnostic modalities, or even peroperatively, rather than by colonoscopy. Five year survival was higher for patients who had at least
one postoperative colonoscopy than for patients who did not underwent surveillance colonoscopy (P<0.001). After the multivariate
analysis, a surveillance program was associated with improved survival (hazard ratio 0.53; 95% confidence interval 0.44-0.64).
Conclusion:
Patients with a history of colorectal cancer have an increased risk for a second colorectal tumour. Therefore, just as
according to national guidelines, we would recommend a surveillance program with a first colonoscopy one year after curative
surgery. Surveillance is associated with improved survival, even after adjustment for covariates.
Biography
Winesh Ramphal is a Surgical Resident and currently, he is pursuing his PhD. His PhD concerns includes patients with a first episode of uncomplicated acute diverticulitis
and patients in the follow up after curative surgery for colorectal carcinoma. Therefore, his PhD is named “follow-up after diverticulitis and colorectal carcinoma”. He has
graduated from Medicine school at the Erasmus Universitiy in Rotterdam, the Netherlands.
w.ramphal@gmail.comWinesh Ramphal, J Gastrointest Dig Syst 2017, 7:5 (Suppl)
DOI: 10.4172/2161-069X-C1-055