Erschienen in:
01.06.2014 | Gastrointestinal Oncology
Is Preoperative Colonoscopy Necessary for Patients Undergoing Gastric Cancer Surgery?
verfasst von:
Toshiyasu Ojima, MD, Makoto Iwahashi, MD, Mikihito Nakamori, MD, Masaki Nakamura, MD, Masahiro Katsuda, MD, Takeshi Iida, MD, Keiji Hayata, MD, Katsunari Takifuji, MD, Shunsuke Yamaguchi, MD, Hiroki Yamaue, MD
Erschienen in:
Annals of Surgical Oncology
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Sonderheft 3/2014
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Abstract
Purpose
The aim of this study was to evaluate the necessity of preoperative colonoscopy (CS) in gastric cancer (GC) patients and to assess the outcomes of different treatments in patients with synchronous GC and colorectal neoplasms (CRN). We also determined the risk factors influencing the comorbidity of colorectal cancer (CRC) in patients with GC.
Methods
This retrospective study included 1891 consecutive GC patients who underwent CS before surgery from January 1, 1999, through June 30, 2012.
Results
There was a high prevalence of concurrent CRN (28.4 %) and CRC (3.2 %) in our patients with GC. Sixty-one patients with GC had synchronous CRC. Twenty-three of the 61 tumors were perioperatively treated by endoscopic resection. The other 38 tumors were treated by simultaneous surgery for the GC and CRC. Surgical complications were not found in either the endoscopic or surgical resection group. The multivariate logistic regression analysis indicated that the prevalence of synchronous CRC in patients with GC was significantly associated with the incidence of multiple GCs [P < 0.0001; odds ratio (OR) 15.3], having anemia (P = 0.002; OR 3.0), and having a smoking history (P = 0.021; OR 1.9).
Conclusions
We recommend preoperative CS screening for GC patients. In particular, preoperative CS screening is indispensable for patients with multiple GCs. In addition, simultaneous treatments for patients with synchronous GC and CRN are safe and feasible procedures.