Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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The Cumulative Recurrence Rate of Colonic Adenomatous Polyps After Colon Polypectomy in a Single University Hospital Health Check-up Examinees

일개 대학병원 건강검진 수진자를 대상으로 한 선종성 대장용종절제술 후 대장용종의 누적재발률

  • Hwang, Hye-Lim (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Jung, Woo-Geun (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Kim, Yun-Jin (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Lee, Sang-Yeoup (Medical Education Unit, Pusan National University School of Medicine) ;
  • Cho, Byung-Mann (Department of Preventive Medicine and Occupational Medicine, Pusan National University School of Medicine) ;
  • Yi, Yu-Hyeon (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Cho, Young-Hye (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Tak, Young-Jin (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Jeong, Dong-Wook (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Lee, Jeong-Gyu (Department of Family Medicine, Pusan National University School of Medicine)
  • 황혜림 (부산대학교 의학전문대학원 가정의학교실) ;
  • 정우근 (부산대학교 의학전문대학원 가정의학교실) ;
  • 김윤진 (부산대학교 의학전문대학원 가정의학교실) ;
  • 이상엽 (부산대학교 의학전문대학원 의학교육실) ;
  • 조병만 (부산대학교 의학전문대학원 예방의학 및 산업의학교실) ;
  • 이유현 (부산대학교 의학전문대학원 가정의학교실) ;
  • 조영혜 (부산대학교 의학전문대학원 가정의학교실) ;
  • 탁영진 (부산대학교 의학전문대학원 가정의학교실) ;
  • 정동욱 (부산대학교 의학전문대학원 가정의학교실) ;
  • 이정규 (부산대학교 의학전문대학원 가정의학교실)
  • Received : 2014.04.21
  • Accepted : 2014.08.18
  • Published : 2014.09.30
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Abstract

Objectives: Colonoscopy is a popular tool for screening for colon cancer throughout the world. The incidence of polypectomy and follow-up colonoscopy are persistently increasing but the studies about follow-up test after polypectomy are still lack of its domestic sources. This study is designed to look into the recurrence rate of colon polyps and risk factors after polypectomy. Methods: This is a retrospective study by reviewing medical charts of 147 patients who underwent polypectomy and follow-up colonoscopy from Jan. 2000 to Mar. 2008. The Kudo classification was used to describe the polyps found in the colonoscopy. The follow-up period was defined as the term between polypectomy and the first colonoscopy follow up. Results: Seventy six point two percent of the enrolled patient were male and the mean age was $56.5{\pm}8.1$. Mean follow-up period was $24.9{\pm}13.7$ (6 - 65) months. The cumulative recurrence rate of 1 year was 11.6%. The rate of 2 years was 36.7% and that of 3 years was 55.8%. The number of polyps was the factor which statistically showed significant relation of its recurrence rate. The histological morphology characteristic of polyps could be one independent factor which may be associated to the recurrence of polyps. Conclusions: The importance of colonoscopy follow up after polypectomy was clearly emphasized through the cumulative recurrence rate of 55.8%. Therefore, there is a need for more domestic studies with a large number of patients about the recurrence of polyps after polypectomy.

대장내시경을 이용한 대장암 선별검사가 증가하면서 발견된 용종의 절제와 추적검사가 점차 많아지고 있다. 하지만 국내에 대장용종절제 후 추적검사에 대한 연구가 부족한 실정이다. 이에 본 연구에서는 대장용종절제술 후 용종의 재발률을 알아보고 재발 위험 인자를 알아보고자 하였다. 이를 위하여 2000년 1월부터 2008년 3월까지 기간 동안에 용종절제술을 시행 받고 이후 추적검사를 시행 받은 147명의 환자를 대상으로 의무기록을 통한 후향적 분석을 시행하였다. 대장내시경검사를 통해 발견된 용종은 Kudo의 분류법으로 기술하였다. 추적 조사기간은 용종절제술과 이후 시행한 추적 대장내시경 검사와의 간격으로 정의하였다. 대상자 중 남자가 76.2%이었고, 환자의 평균연령은 $56.5{\pm}8.1$세이었다. 대상자의 용종절제 후 평균 추적기간은 $24.9{\pm}13.7$(6 - 65)개월이었다. 1년 누적재발률은 11.6%, 2년 누적재발률은 36.7%이고, 3년 누적재발률은 55.8%이었다. 용종의 개수에 따라 재발율이 유의한 차이를 보였다. 용종의 재발여부에 독립적인 영향을 미치는 인자로는 조직학적 형태가 의미있는 인자로 조사되었다. 본 연구 결과 대장의 선종성 용종의 3년 누적재발률이 55%를 넘는 것으로 관찰되므로 대장용종절제 후 추적 대장 내시경의 중요성이 강조되며 향후 대장용종절제술 후 재발에 대한 국내의 대규모 연구가 이루어져야 할 것으로 보인다.

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References

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