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Acta Endoscopica

, 25:81 | Cite as

Les adénomes colorectaux Critères de surveillance endoscopique

  • J. Faivre
  • P. Senesse
  • C. Michiels
Article
  • 2 Downloads

Résumé

Le développement de l’endoscopie conduit de plus en plus souvent au diagnostic d’adénome. Cette population est globalement à risque élevé de cancer colorectal. Cette situation pose le problème de surveillance endoscopique après exérèse d’un adénome. Des données convergentes suggèrent que seuls les sujets atteints d’adénome villeux ou tubulovilleux et les sujets atteints d’un adénome tubuleux de plus de 1 cm de diamètre constituent une population à risque élevé de cancer colorectal, surtout si les adénomes sont multiples. Deux études de cohorte indiquent que la surveillance endoscopique après polypectomie diminue l’incidence ou la mortalité par cancer colorectal. Des données récentes suggèrent que dans le groupe à risque élevé de cancer colorectal, une surveillance endoscopique tous les 3 ans est suffisante. Une surveillance plus fréquente n’est justifiée qu’après exérèse d’un gros adénome sessile ou d’un polype malin pour vérifier le caractère complet de l’exérèse, puis pour éliminer une récidive locale.

Mots-clés

adénome polypectomie surveillance endoscopique 

Colorectal adenomas Criteria for endoscopic surveillance

Summary

With the development of colonoscopy, adenomas are detected more frequently. This population is at increased risk of colorectal cancer. This situation raises the question of endoscopic surveillance after endoscopic polypectomy. Converging data suggest that colorectal cancer risk is increased only in subjects with a villous or tubulovillous adenoma and subjects with a tubular adenoma more than 1 cm in diameter, particularly if they were multiple. Two cohort studies indicate that endoscopic surveillance is effective to reduce colorectal cancer incidence or mortality. Recent date indicate that, in the high risk group for colorectal cancer, an interval of three years is sufficient before performing a follow-up colonoscopy. A more agressive surveillance is justified only in patients with large sessile adenomas or malignant polyps to ensure complete polypectomy and exclude local recurrence.

Key-words

adenoma colonoscopic surveillance polypectomy 

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Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • J. Faivre
    • 1
  • P. Senesse
    • 1
  • C. Michiels
    • 1
  1. 1.Faculté de MédecineDijon CedexFrance

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