Información del artículo
Resumen
Los adenomas colorrectales constituyen la lesión premaligna mejor caracterizada en el desarrollo del cáncer colorrectal. Por este motivo, la identificación y la resección de estas lesiones y el seguimiento de los pacientes que las han presentado son objetivos fundamentales en la prevención de esta neoplasia. Los estudios presentados en el congreso de la American Gastroenterological Association demuestran que es posible mejorar los resultados obtenidos con las estrategias de vigilancia actuales con el fin de disminuir la tasa de neoplasias de intervalo. La mejora de estos resultados incluye la optimización de la técnica endoscópica (preparación colónica, intubación cecal, tiempo de retirada, etc.), así como la incorporación de nuevas modalidades diagnósticas y la posible administración de fármacos quimiopreventivos.
Palabras clave:
Adenoma colorrectal
Vigilancia
Prevención
Cáncer colorrectal
Endoscopia
Pólipo
Abstract
Colorectal adenomas are the most fully characterized premalignant lesions in the development of colorectal cancer. Consequently, the identification and resolution of these lesions, as well as the follow-up of affected patients, are a priority in the prevention of this neoplasm. The studies presented in the annual meeting of the American Gastroenterological Association 2008 show that the results of current surveillance strategies can be improved with a view to reducing the rate of interval neoplasia. Improvement of these results includes optimization of the endoscopic technique (colonic preparation, cecal intubation, withdrawal time, etc.) as well as the incorporation of new diagnostic methods and the possible administration of chemopreventive drugs.
Key words:
Colorectal adenoma
surveillance
prevention
colorectal cancer
endoscopy
polyp
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Bibliografía
[1.]
W.S. Atkin, B.P. Saunders.
Surveillance guidelines after removal of colorectal adenomatous polyps.
Gut, 51 (2002), pp. V6-V9
[2.]
S.J. Winawer, A.G. Zauber, M.N. Ho, M.J. O’Brien, L.S. Gottlieb, S.S. Sternberg, et al.
Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup.
N Engl J Med, 329 (1993), pp. 1977-1981
[3.]
D.K. Rex, J.H. Bond, S. Winawer, T.R. Levin, R.W. Burt, D.A. Johnson, et al.
Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer.
Am J Gastroenterol, 97 (2002), pp. 1296-1308
[4.]
A. Castells, M. Marzo, B. Bellas, F. Amador, A. Lanas, J. Mascort, et al.
Guía de práctica clínica en prevención del cáncer colorrectal.
Gastroenterol Hepatol, 27 (2004), pp. 573-634
[5.]
S.J. Winawer, A.G. Zauber, H. Gerdes, M.J. O’Brien, L.S. Gottlieb, S.S. Sternberg, et al.
Risk of colorectal cancer in the families of patients with adenomatous polyps. National Polyp Study Workgroup.
N Engl J Med, 334 (1996), pp. 82-87
[6.]
S.J. Winawer, A.G. Zauber, R.H. Fletcher, J.S. Stillman, M.J. O’Brien, B. Levin, et al.
Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society.
Gastroenterology, 130 (2006), pp. 1872-1885
[7.]
A.O. Laiyemo, P.F. Pinsky, P. Marcus, E. Lanza, A.J. Cross, A. Schatzkin, et al.
The continue follow-up study of the Polyp Prevention Trial: a prospective study of utilization and yield of surveillance colonoscopy.
Gastroenterology, 134 (2008), pp. A111
[8.]
K. Leung, P.F. Pinsky, A.O. Laiyemo, E. Lanza, A. Schatzkin, R. Schoen.
The Polyp Prevention Trial Continued Follow-Up Study: ongoing colorectal cancer risk despite surveillance colonoscopy.
Gastroenterology, 134 (2008), pp. A114
[9.]
D. Robertson, D. Lieberman, S. Winawer, D. Ahnen, E. Robert Greenberg, J. Baron, et al.
Interval cancer total colonoscopy: results from a pooled analysis of eight studies.
Gastroenterology, 134 (2008), pp. A111
[10.]
A. Pabby, R.E. Schoen, J.L. Weissfeld, R. Burt, J.W. Kikendall, P. Lance, et al.
Analysis of colorectal cancer occurrence during surveillance colonoscopy in the dietary Polyp Prevention Trial.
Gastrointest Endosc, 61 (2005), pp. 385-391
[11.]
D. Lieberman, M. Nadel, R.A. Smith, W. Atkin, S.B. Duggirala, R. Fletcher, et al.
Standardized colonoscopy reporting and data system: report of the Quality Assurance Task Group of the National Colorectal Cancer Roundtable.
Gastrointest Endosc, 65 (2007), pp. 757-766
[12.]
D.K. Rex, J.L. Petrini, T.H. Baron, A. Chak, J. Cohen, S.E. Deal, et al.
Quality indicators for colonoscopy.
Gastrointest Endosc, 63 (2006), pp. S16-S28
[13.]
D.K. Rex, J.L. Petrini, T.H. Baron, A. Chak, J. Cohen, S.E. Deal, et al.
Quality indicators for colonoscopy.
Am J Gastroenterol, 101 (2006), pp. 873-885
[14.]
R.L. Barclay, J.J. Vicari, A.S. Doughty, J.F. Johanson, R.L. Greenlaw.
Colonoscopic withdrawal times and adenoma detection during screening colonoscopy.
N Engl J Med, 355 (2006), pp. 2533-2541
[15.]
Z.F. Gellad, D.G. Weiss, D. Ahnen, D. Lieberman, G.L. Jackson, D. Provenzale.
Colonoscopy withdrawal time and risk of neoplasia on follow-up colonoscopy: results from VA Cooperative Study Program 380.
Gastroenterology, 134 (2008), pp. 261
[16.]
A. Taber, J. Romagnuolo.
Simply recording colonoscopy withdrawal time increases polyp detection rate.
Gastroenterology, 134 (2008), pp. 262
[17.]
O. Lin, R.A. Kozarek.
The effect of periodic monitoring on screening colonoscopy withdrawal times, polyp detection rates and patient satisfaction scores.
Gastroenterology, 134 (2008), pp. 263
[18.]
M.Y. Chan, H. Cohen, B.M. Spiegel.
Does the first colonoscopy of the day yield more polyps than cases performed later?.
Gastroenterology, 134 (2008), pp. A37
[19.]
S.A. Gross, A.M. Buchner, J.R. Cangemi, H.C. Wolfsen, K.R. DeVault, J. Crook, et al.
A prospective randomized back-to-back trial comparing narrow band imaging to conventional colonoscopy for adenoma detection.
Gastroenterology, 134 (2008), pp. A47
[20.]
J. Pohl, E. Lotterer, M.F. Sackmann, M. Medve, C. Ell.
A prospective randomized multicenter study on the Fujinon Intelligent Colour Enhancement system versus standard colonoscopy with targeted indigocarmine chromoendoscopy: what is the impact of novel optical imaging techniques on polyp detection rates?.
Gastroenterology, 134 (2008), pp. 768
[21.]
M. Pellise, G. Fernandez-Esparrach, A. Cardenas, O. Sendino, E. Ricart, E. Vaquero, et al.
Clinical impact of wide-angle, high-resolution endoscopy in the diagnosis of colorectal neoplasia in a non-señected population: a prospective, randomized controlled trial.
Gastroenterology, 134 (2008), pp. 769
[22.]
M. Goetz, A. Ziebart, M. Vieth, P.M. Delaney, P.R. Galle, M.F. Neurath, et al.
In vivo molecular imaging of colorectal cancer by confocal endomicroscopy.
Gastroenterology, 134 (2008), pp. A48
[23.]
J.D. Waye, R. Heigh, D.E. Fleischer, J.A. Leighton, L.B. Aldrich, J. Li, et al.
A prospective efficacy evaluation of the third eye retroscope auxiliary endoscopy system.
Gastroenterology, 134 (2008), pp. 770
[24.]
J. Deviere, M.A. Muñoz-Navas, I. Fernandez-Urien, C. Carretero, G. Gay, M. Delvaux.
PillCam colon capsule endoscopy compared to colonoscopy in detection of colon polyps and cancers.
Gastroenterology, 134 (2008), pp. A38
[25.]
J.A. Baron, B.F. Cole, R.S. Sandler, R.W. Haile, D. Ahnen, R. Bresalier, et al.
A randomized trial of aspirin to prevent colorectal adenomas.
N Engl J Med, 348 (2003), pp. 891-899
[26.]
A.T. Chan, E. Giovannucci, C.S. Fuchs.
Aspirin and non-steroidal anti-inflammatory drug use and the risk of colorectal cancer according to plasma inflammatory markers.
Gastroenterology, 134 (2008), pp. A113
[27.]
J.A. Baron, R.S. Sandler, R.S. Bresalier, H. Quan, R. Riddell, A. Lanas, et al.
A randomized trial of rofecoxib for the chemoprevention of colorectal adenomas.
Gastroenterology, 131 (2006), pp. 1674-1682
[28.]
N. Arber, C.J. Eagle, J. Spicak, I. Racz, P. Dite, J. Hajer, et al.
Celecoxib for the prevention of colorectal adenomatous polyps.
N Engl J Med, 355 (2006), pp. 885-895
[29.]
R.S. Bresalier, R.S. Sandler, H. Quan, J.A. Bolognese, B. Oxenius, K. Horgan, et al.
Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial.
N Engl J Med, 352 (2005), pp. 1092-1102
[30.]
N. Arber.
Chemopreventive effectiveness of celecoxib two years after cessation of treatment.
Gastroenterology, 134 (2008), pp. 361
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