Risk Factors For Recurrence And Surveillance Strategy Of Colorectal Adenomas After Polypectomy

Objective To analysis of the risk factors associated with recurrent colorectal adenomatous polyps and explore the effective clinical surveillance strategy after polypectomy.Methods A total of 327 patients undergoing polypectomy and taken 1-4 times surveillence colonosopy within 4-95 months were retrospectively analyzed.The characteristics of adenomas were recorded on initial colonoscopy,including age,gender,number, size, pathological type and degree of atypical hyperplasia; We defined a new adenomas or cancer as a significant outcome on the surveillance colonoscopy,analysis of the risk factors associated with recurrence and the relations of recurrence rate and surveillance interval.Results 327 patients in the multiple regression analysis showed that the risk factors of adenomas recurrence include polyp diameter, number, pathological type and degree of atypical hyperplasia, not include age and gender. We can defined the high-risk adenomas(number≥3, diameter≥1cm, tubulovillous or villous adenoma and high-grade dysplasia) and the low-risk adenomas(1 or 2 less than 1cm in diameter, tubular adenomas and without high-grade dysplasia).Compared with the low-risk group, the high-risk group had a significant raise of comulative hazard of recurrence, the recurrence rate of low-risk group has not a significant difference in the surveillance interval within 3 years,3-5 years or over 5 years; conversely, a significant difference in high-risk group in the same surveillance interval.Conclusions Among our patients, the recurrence rate of adenoma after polypectomy increased with polyp size, number, tubulovillous or villous adenoma and high-grade dysplasia. We can classify adenoma patients into high risk groups or low risk groups by risk stratification of adenomas,and save the medical resource of surveillance colonosopy.