Incidental Polyp on Colectomy Specimen is Linked with Higher Odds of Polyp on Interval Colonoscopy
| Autor: | James F. FitzGerald, Jennifer M. Ayscue, Brenna K. Houlihan, Mohammed Bayasi, Sara E. Berkey, Timothy J. Holleran, Brian L. Bello, Aradhya Nigam |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test Colorectal cancer business.industry medicine.medical_treatment Colonoscopy Colonic Polyps medicine.disease digestive system diseases Confidence interval Odds Surgical pathology New Lesion Identification Risk Factors otorhinolaryngologic diseases medicine Humans Surgery Radiology Risk factor business Colectomy Retrospective Studies |
| Zdroj: | The Journal of surgical research. 268 |
| ISSN: | 1095-8673 |
| Popis: | Background Incidentally found polyps on surgical pathology after colectomy is an underreported phenomenon, and management guidelines are lacking. Elucidation of the significance of incidental polyps is needed to determine if post-operative endoscopic surveillance modification is warranted. We sought to determine the relationship between incidental polyp on colectomy specimen and findings on post-operative colonoscopy. Materials and Methods A multi-institutional retrospective review was performed on patients that underwent colorectal resection from 2018-2019. Surgical pathology was reviewed for polyps and assigned as expected or incidental based on pre-operative colonoscopy. If performed, post-operative colonoscopy was reviewed for new lesion identification. The odds of detecting new lesion on post-operative colonoscopy was compared between cases with incidental polyp on surgical specimen and patients without incidental findings. Results In 243 colorectal resections, incidental polyps were identified in 55 cases(22.6%). Post-operative colonoscopy was completed in 65 cases(26.7%) with new polyp detected in 24 cases(9.88%). Of those, 10 had an incidental polyp previously identified on surgical specimen while 14 did not. The presence of incidental surgical specimen polyp was associated with a greater than two-fold higher odds of detecting new polyp on post-operative colonoscopy(odds-ratio 2.76, 95% confidence interval 1.15-6.63;P = 0.023). Conclusion This analysis revealed a high frequency of incidental polyps on surgical specimens with an increased rate of newly found lesions on post-operative colonoscopy. Incidental polyps may be a risk factor for other missed lesions still within the patient. Therefore, providers should consider surveillance interval modification on an individual basis in the setting of incidental surgical specimen polyps. |
| Databáze: | OpenAIRE |
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