Detection and treatment of synchronous lesions in colorectal cancer: The clinical implication of perioperative colonoscopy

Table 1 Distribution of primary carcinoma by stage (TNM stage) and site

Site	Stage
	I	II	III	IV	Total
Ascending colon	16	22	16	3	57
Transverse colon	5	6	8	2	21
Descending colon	3	6	5	1	15
Sigmoid colon	22	27	43	3	95
Rectum	32	37	54	5	128
Total	78	98	126	14	316

Table 2 Characteristics of synchronous lesions

Characteristics	Number of lesions	%
Location of polyps
Ascending colon	48	17.0
Transverse colon	39	13.8
Descending colon	18	6.4
Sigmoid colon	93	33.0
Rectum	84	29.8
Size of polyp (mm)
< 5	77	27.3
5-10	109	38.7
10-15	56	19.8
15-20	23	8.2
> 20	17	6.0
Histology
Carcinoma	19	6.7
Adenomatous polyp	158	56.0
Tubular	93
Villo-tubular	37
Villous	28
Hyperplastic polyp	78	27.7
Others	27	9.6
Total number of polyps	282	100

Table 3 Treatment of synchronous lesions

	No. of patients withsynchronous lesions	No. of lesions
Preoperative colonoscopy cases (n = 265)	1051	255
Preoperative polypectomy	77	156
Surgical removal	37	99
Included within specimen	18	51
Segmental resection	6	12
Enterotomy/wedge resection	10	15
Subtotal colectomy	3	21
Intraoperative colonoscopy cases (n = 51)	19	33
Endoscopic polypectomy	5	7
Surgical removal	7	13
Segmental resection	3	7
Enterotomy	4	6
Included within specimen2	7	13
Total	124	282

¹Dual procedure were performed for some patients, therefore, the sum exceeds the total number of patients.

²These lesions were not recognized until postoperative specimen examination.

Table 4 Incidence of complications

Time of colonoscopies	Number of patients (%)
Preoperative colonoscopy (n = 265)
Anastomosis leakage	4 (1.5)
Intraabdominal sepsis	3 (1.1)
Wound infection	7 (2.6)
Intraoperative colonoscopy with bowel preparation (n = 42)
Anastomosis leakage	1 (2.4)
Intraabdominal sepsis	1 (2.4)
Wound infection	3 (4.7)
Intraoperative colonoscopy with intraoperative colon lavage (n = 9)
Anastomosis leakage	0
Intraabdominal sepsis	0
Wound infection	2