Preoperative repeat endoscopy for colorectal cancer: What is its role and when is it necessary?

Preoperative repeat endoscopy for colorectal cancer: What is its role and when is it necessary?

Can J Surg 2016;59(6):427-28 | PDF

Woo Jin Choi, BSc; Michelle C. Cleghorn, MSc; Fayez A. Quereshy, MD, MBA

Summary

Many surgeons consider repeat endoscopy to be the standard of care for colorectal cancer; however, its utility in the preoperative setting is not well understood, especially given the lack of standardized guidelines on appropriate tumour localization and colonoscopic reporting. This often results in patients undergoing an unnecessary medical procedure during their preoperative evaluation. We discuss some of the issues surrounding the practice of preoperative repeat endoscopy as well as patient perspectives on the procedure. Our observations suggest that repeat endoscopy in the setting of colorectal cancer surgery may play a role in enabling transition of patient care between the initial endoscopist and the treating surgeon and in improving the patient experience. Patients with operable colorectal cancer appear to understand and support the current use of repeat endoscopy. However, improving preoperative care will require further research and ultimately the development of evidence-based clinical guidelines.


Accepted May 16, 2016; Early-released Oct. 1, 2016

Affiliations: From the Division of General Surgery and Surgical Oncology, University Health Network, Toronto, Ont.

Competing interests: None declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.005116

Correspondence to: F.A. Quereshy, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Rm 8MP-320, Toronto ON M5T 2S8; fayez.quereshy@uhn.ca