ENDOSCOPIC ABNORMALITIES OF THE ANASTOMOSIS FOLLOWING RESECTION OF COLONIC NEOPLASM

When 321 patients with resections for colonic neoplasms were prospecti vely evaluated for changes occurring at the anastomosis, eight differe nt kinds were found (118 abnormalities seen in total). Inflammatory po lyps, the most commonly observed abnormality (14.5%), may be misinterp reted as recurrent neoplasia by endoscopy. The majority of inflammator y polyps were discrete, 5- to 15-mm lesions, although diffuse nodulari ty was occasionally seen. Staples or sutures were visible at 11.3% of the anastomoses. Benign strictures, which developed in 7.1%, occurred primarily after left colonic resection with end-to-end anastomosis. Pr ominent vessels were occasionally seen at the anastomotic site (3.9%). Recurrent carcinoma at the anastomosis was found in 6 of 116 patients with Dukes B and C tumors (5.2%) and occurred 0.4 to 2.0 years after surgery (mean, 1.2 years). Recurrent carcinoma appeared as ulcerated s ubmucosal lesions, bulky luminal masses, and polypoid lesions. In two patients, mucosal erythema, edema, and friability at the anastomosis w ere the only endoscopic evidence of underlying carcinoma.