Biomedical subjects

L C Rusin

Publications and source records attributed to L C Rusin.

21 records · Page 2Linked to original sources

PubMed1991

Documenting the use of fluoroscopy during colonoscopic examination: a prospective study.

To determine the patterns of fluoroscopy use during colonoscopy, 500 consecutive patients undergoing colonoscopic examination were studied over a 6-month period. The procedures were performed on 195 patients by three gastroenterologists and on 305 patients by three colon and rectal surgeons. The study group comprised 237 women and 263 men aged an average of 62 years (range, 12-90 years). The results revealed that fluoroscopy was used during 37% of colonoscopic examinations. The most common indications for fluoroscopy were the treatment of sigmoid loops (42%) and the localization of the colonoscope tip (51%), totaling 93% of 312 fluoroscopic checks. The suspected position of the colonoscope tip was inaccurate in 15% (47/312) of fluoroscopic checks. The most common bowel location of the colonoscope tip during the fluoroscopic checks was the hepatic flexure (24%), followed by the cecum (21%). In all, 53% (166/312) of fluoroscopic checks involved the right colon. The selective use of fluoroscopy during more difficult cases was emphasized by the significantly longer time required for the procedure (36 vs 26 min) and the significantly lower cecal intubation rate (79% vs 99%). In summary, fluoroscopy is deemed to be a safe, reliable technique that facilitates the completion of difficult colonoscopic examinations. It is especially helpful in the treatment of sigmoid loops and in the precise localization of the position of the colonoscope tip, especially during negotiation of the right colon.

Adolescent↗

PubMed1982

Colonoscopy: its role in cancer of the colon and rectum.

In order to determine the feasibility, yield, and impact of routine total colonoscopy on the management of large-bowel cancer, 157 cancer patients underwent 175 colonoscopic procedures; 13.6 per cent of the cancers had been missed on double-contrast barium enema examination. Among 92 patients undergoing perioperative colonoscopy, the lesion was reached in 90 per cent and the cecum in 60 per cent; 7.6 per cent demonstrated synchronous cancers, all curable, and all missed on barium-enema examination. Seventy-eight patients underwent colonoscopy at an average of 3.7 years after treatment of the index cancer; 7.7 per cent demonstrated metachronous cancers, all curable, two-thirds of which were missed on barium-enema examination. Benign polyps were noted in 62 per cent of the patients studied; 77 per cent of those polyps, 1 cm or greater in size, were missed on barium-enema examination. Polyps were found proximal to the cancer in 60 per cent of the patients with polyps. Approximately 85 per cent of those with multiple cancers demonstrated benign polyps. Preoperative total colonoscopy with periodic postoperative colonoscopy at an interval of three to five years are essential in the reliable detection of synchronous cancers and for the detection of metachronous cancers at an earlier, more favorable stage.

Cecal Neoplasms↗

PubMedDate not supplied

The reliability of cecal landmarks during colonoscopy.

Confirming colonoscopic intubation of the cecum can be a laborious, time-consuming, and often frustrating endeavor. Anatomic landmarks may offer visual clues of cecal intubation, but the predictability of this evidence is unclear. The presence of three cecal landmarks, alone and in combination, were evaluated to precisely define their reliability. Between February and October of 1991, 601 of 708 (85%) consecutive colonoscopic examinations were able to be completed to the cecum as confirmed by fluoroscopy. All three cecal landmarks studied were present in 64% (386/601), two cecal landmarks in 32% (189/601), and one cecal landmark in 4% (26/601) of the patients. Therefore, at least two cecal landmarks were identified in 96% (575/601) of the patients. The ileocecal sphincter was identified in 98% (591/601) of patients overall, in 98% (185/189) of patients and 2 cecal landmarks, and in 77% (20/26) of patients with 1 cecal landmark. The appendiceal orifice was seen in 87% (524/601) of patients overall and in 72% (137/189) of patients with 2 cecal landmarks. Transillumination through the abdominal wall was possible in 74% (447/601) of patients overall and in 30% (56/189) of patients with 2 cecal landmarks. In summary, the ileocecal sphincter is the most reliable cecal landmark and is invariably visualized, even when all other landmarks are obscure. While other cecal landmarks, such as the appendiceal orifice and transillumination, are consistently identified, they are most valuable when found in association with the ileocecal sphincter.

Cecum↗