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At least 1,459 records · Page 81Linked to original sources
PubMed2005

Is colonoscopy sufficient for colorectal cancer surveillance in all HNPCC patients?

A 34-year-old male with hereditary non-polyposis colon cancer with a mutation in hMSH2 line is reported. Despite regular colonoscopic follow-up, he developed cecal cancer involving the extraluminal area. Due to sub-occlusive symptoms, the patient was submitted to further colonoscopy, however with no clear evidence of neoplasia. Thin slice multiplanar reconstruction computed tomography CT scan performed thereafter revealed a transmural mass 2.5 cm in size localized near the cecal valve. Discussion is made on the reliability of colonoscopic examinations as well as the need for further investigations in the follow-up of patients at very high risk of right-sided colon cancer, such as male hMSH2 carrier affected by hereditary non-polyposis colon cancer.

Adult↗
PubMed1996

Bowel preparation before colonoscopy. Choosing the best lavage regimen.

A review of the relevant English-language literature on bowel cleansing before colonoscopy yielded results of randomized trials comparing a variety of regimens, including polyethylene glycol (PEG)-electrolyte lavage, 3-day clear liquid diet with laxatives or prokinetics, and oral sodium phosphate, as well as these regimens combined with agents such as metoclopramide, cisapride, and senna. Balancing the importance of such factors as cleansing effectiveness, safety, ease of completion, side effects, patient tolerance, and cost, the authors recommend four methods: (1) PEG-electrolyte solution (eg, CoLyte, GoLYTELY, NuLytely) in combination with senna (eg, X-Prep), (2) PEG-electrolyte solution alone (either single dose or split dose), (3) oral sodium phosphate (Fleets Phosphosoda) given in split dose, and (4) oral magnesium citrate in combination with rectal pulsed irrigation.

Administration, Oral↗
PubMed2004

Predicting adherence to colonoscopy or flexible sigmoidoscopy on the basis of physician appointment-keeping behavior.

BACKGROUND: Poor patient attendance to scheduled flexible sigmoidoscopy or colonoscopy may contribute to deficient colorectal cancer screening. OBJECTIVE: To examine the association of physician appointment-keeping behavior with attendance to scheduled endoscopic studies of the colon. DESIGN: Retrospective cohort. SETTING: 23 sites performing endoscopic procedures in a health care system. PATIENTS: 11 803 patients scheduled for a first colon study with 3 or more scheduled physician visits from June 1999 through November 2001. MEASUREMENT: 2 outcomes from health system computerized records: 1) attendance at the first scheduled colon study and 2) among nonattendees, attendance at the study rescheduled within 6 months. Physician visit adherence was defined as the proportion of physician visits kept, grouped by quartile. Adjusted associations were examined in conditional logistic regression. RESULTS: Of 11 803 patients, 62% attended the first colon study. Of the 4496 nonattendees, 2739 (61%) rescheduled and, of these, 64% kept that appointment. Compared with the highest quartile of physician visit adherence (>85%), the adjusted odds ratio of attending the first colon study decreased as physician visit adherence decreased: Adjusted odds ratios were 0.94 (95% CI, 0.89 to 1.00) for 76% to 85% adherence, 0.87 (CI, 0.81 to 0.92) for 66% to 75% adherence, and 0.79 (CI, 0.73 to 0.85) for adherence of 65% or less. Among nonattendees who rescheduled, the lowest quartile of physician visit adherence (< or =65%) was the only statistically significant predictor of attending the rescheduled study (adjusted odds ratio, 0.87 [CI, 0.78 to 0.98]). LIMITATIONS: The adherence measure applies only to patients with at least 3 scheduled visits. Persons having a colon study outside of the system could have been misclassified. CONCLUSION: Physician appointment-keeping behavior predicted attendance to colorectal endoscopic studies in this cohort and may help identify persons who need interventions to promote adherence.

Aged↗
PubMedDate not supplied

[Colonoscopy as a diagnostic and therapeutic method in large intestine diseases. Results of 1715 exams].

Widespread use of colonoscopy in clinical practice results from the continuous progress of the techniques developed for exam completion and from the therapeutic perspective for several colorectal conditions. This paper analyses in a retrospective basis the results associated to the employment of fibrocolonoscopy between 1984 and 1995 at Discipline of Coloproctology from the University of São Paulo School of Medicine. For this period, 1,715 exams were realized. More than 50% of the patients were between the 50th and 70th decade. Habit change of hemorrhage were indications for the exam in more than 35%. Inflammatory bowel disease and cancer follow-up were indications, respectively, in 18% and 16%. "Express mannitol" bowel prep resulted satisfactory in more than 97% but precluded complete exam for seven (0.4%) patients. In 42.5%, colonoscopic examination was normal. Polyps were found in 248 (14.5%) patients for whom 376 polypectomy procedures were done successfully. Endoscopists could not reach the cecum in 68 (3.9%) patients. Incidence of hemorrhage and perforation was nill for this series. Authors conclude that fibrocolonoscopy remains as a safe and efficient method for the diagnosis and treatment (polypectomy) of common colorectal conditions.

Adult↗
PubMed1999

Virtual colonoscopy--technique and applications.

Virtual colonoscopy is a new method for evaluating the colon which uses thin section computed tomography of the clean air distended colon. The acquired computed tomography data is then subjected to computer manipulation to demonstrate the colonic mucosa. It is a safe, non-invasive, well-tolerated method that has potential as a method of colorectal cancer screening. This review will describe the technique, review preliminary results, and discuss the present and future applications of this technique.

Colon↗
PubMedDate not supplied

[Massive trichuriasis in an adult diagnosed by colonoscopy].

A case of massive trichuriasis in a 37-year-old female from a rural locality of the Metropolitan Region of Chile, with antecedents of alcoholism, chronic hepatic damage and portal cavernomatosis, is presented. Since 12 year ago she has had geophagia. In the last six months she has frequently presented liquid diarrhea, colic abdominal pains, tenesmus and sensation of abdominal distention. Clinical and laboratory tests confirmed her hepatic affection associated with a celiac disease with anemia and hypereosinophilia. Within a week diarrhea became worse and dysentery appeared. A colonoscopy revealed an impressive and massive trichuriasis. The patient was successfully treated with two cures of 200 mg tablets of mebendazole twice daily for three days with a week interval. After the first cure she evacuated a big amount of Tricuris trichiura, fecal evacuations became normal, geophagia disappeared and recovered 4 kg of body weight.

Adult↗
PubMed2000

Colonic adenomas: prevalence and incidence rates, growth rates, and miss rates at colonoscopy.

Cost-effective use of colonic imaging studies can be achieved through an understanding of the prevalence, incidence, growth, and miss rates of colon adenomas. High adenoma prevalence rates are associated with increasing age, male gender, and a family history of colorectal cancer or multiple first-degree relatives with colorectal neoplasia or neoplasia diagnosed at a young age. The incidence rate of advanced adenomas is higher in patients with multiple adenomas and is likely also associated with a family history of colorectal cancer, increased age, and large adenoma size at the index examination. Direct observational data on growth rates suggests that adenomas <1 cm in size have a fairly stable size over a 3-year interval. Although colonoscopy is the most sensitive colonic imaging study, substantial miss rates for small adenomas are inherent to the procedure. Advancements in endoscopic technology should lead to reduced miss rates, allowing expansion of intervals between examinations while reducing negative outcomes of fatal interval cancers.

Adenoma↗
PubMed2001

Laparoscopic repair of colonic perforation associated with colonoscopy: use of passing sutures and endoscopic linear stapler.

Laparoscopic surgery recently has been conducted to repair colonic perforation that is associated with colonoscopy. The authors describe their laparoscopic repair of perforation using passing sutures and an endoscopic linear stapler. One 12-mm and several 5-mm trocars were inserted in the lower abdomen under general anesthesia. Observing with a laparoscope, passing sutures were threaded transversely through all layers of the margin of defect and pulled up with forceps to hold the margin straight, along which the defect was stapled with an endoscopic linear stapler. The authors applied this method for five patients, where the perforation occurred in the sigmoid colon or in the cecum (perforation size ranging from 10 mm to 50 mm). Perforation was successfully repaired in all patients, with no complications because of perforation or the procedures. The current method is beneficial because the perforated lesion is safely and easily closed and postoperative colonic stenosis is avoided.

Aged↗
PubMed2001

[Prospective randomized single-blind trial comparing oral sodium phosphate with polyethylene glycol for colonoscopy preparation].

AIM AND METHODS: The aim of this prospective, randomized, study performed in 60 outpatients was to compare 2 precolonoscopy bowel preparations: oral sodium phosphate (NaP) versus standard polyethylene glycol-based lavage solution (PEG). None of the patients met any of NaP exclusion criteria. All patients were prepared on the day prior to colonoscopy. A patient-questionnaire and measure of serum electrolytes (calcium, phosphate, sodium, potassium), pulse and blood pressure were used to assess tolerance and acceptability of the preparation. The quality of colon cleansing was judged by blinded endoscopists. RESULTS: Patient's tolerance to NaP was superior to PEG: NaP preparation was easier to drink and feelings of abdominal plenitude occurred in a smaller proportion of patients. A potassium decrease, a sodium increase and hyperphosphatemia were observed in the NaP group but without clinical events. PEG preparation seemed to allow a better cleansing ability compared with NaP but this difference was not statistically significant. CONCLUSIONS: NaP solution was better tolerated and accepted by patients. Colonic preparation quality compared to PEG is still to be discussed depending on the intake schedule. A biochemical data check seems necessary on account of significant serum electrolytes changes induced by NaP preparation.

Adult↗
PubMed2000

[Splenic rupture: a rare complication of colonoscopy].

Splenic rupture due to colonoscopy is very rare. Only a few cases have been reported previously in the English literature. Authors present their own case and they call attention to the mechanism of this complication. They conclude consequences from the literature.

Aged↗
PubMed2001

[Conventional colonoscopy and colonography with magnetic resonance in the diagnosis of endoluminal lesions of the colon].

The diagnostic ability of Magnetic Resonance Colonography (MRC) in detecting colonic endoluminal masses was compared with that of conventional colonoscopy (CC) and related to the findings from histologic examination. In seventy consecutive patients MRC achieved a diagnostic accuracy similar to CC. Therefore MRC could be useful in screening patients at high risk for colonic cancer. However every patient with MRC-detected endoluminal lesion must undergo CC for histologic diagnosis.

Colonoscopy↗
PubMedDate not supplied

[Colonic perforation in patients undergoing colonoscopy].

Colonic perforations associated with colonoscopy are uncommon. We determined the incidence, clinical presentation, and medical and surgical treatments of iatrogenic colon perforations. We present the medical records of 8 patients with iatrogenic colorectal perforations seen over a period of 17 years. The median age 68.3 years. Emergency laparotomy was performed in 7 patients. One case was treated with a medical approach. One postoperative death occurred. In the absence of significant contamination primary repair is the best treatment. Non-operative management is indicated in patients without peritoneal irritation.

Aged↗
PubMedDate not supplied

[Anesthesiological care of fiber colonoscopy in cancer patients].

Various methods of total anesthesia for colonoscopy in cancer patients, carried out in a outpatient setting, are compared. Diprivane and dormicum were used as monoanesthesia and in combinations with ketamine and fentanyl. Diprivane anesthesia was the optimal as regards the velocity of recovery of psychophysiological functions. Ketamine was acknowledged inefficient because of long awakening and psychotic effects.

Adult↗
PubMed2001

Colonoscopy and enteroscopy.

This article focuses on technique and clinical application of ileocolonoscopy and enteroscopy in children. The impact of endoscopic investigations and therapies on specific disease processes and comparison with alternative methods are discussed. Pediatric colonoscopy and enteroscopy differ significantly from their adult counterparts in nearly every aspect. The goals of this article are to highlight those differences and to provide a workable guide for those involved or training in the discipline of pediatric endoscopy.

Child↗
PubMed2001

Comparison of CT virtual endoscopy with electronic colonoscopy in 30 colonic carcinoma patients.

OBJECTIVE: To evaluate the clinical application of CT virtual endoscopy (CTVE) in the diagnosis and treatment of colonic carcinoma. METHODS: We collected 30 patients pathologically proven to have colonic carcinomas as examined by CTVE and electronic colonoscopy (EC), correlating the CTVE and EC images respectively with surgical pathology in three aspects: tumor morphological features, degree of circumferential bowel wall involvement and longitudinal extent of tumor. RESULTS: CTVE imaging of colonic carcinomas showed morphological features: polypoid pattern (11 patients), ulcerative pattern (11), and infiltrative pattern (8); degree of circumferential bowel wall involvement: less than 1/2 (4 patients), from 1/2 to 3/4 (6), and more than 3/4 (20); and their longitudinal extent: 1.0-3.0 cm (7 patients), 31-5.0 cm (10), and 5.1-11.0 cm (13). Correlation of CTVE and EC with surgical pathology was found. Comparison of CTVE with surgical pathology showed tumor morphological features: concordant (26 patients), and disconcordant (4); degree of circumferential bowel wall involvement: concordant (25), disconcordant (5); and longitudinal extent of the tumor: concordant (23), disconcordant (7). Comparison of EC with surgical pathology showed tumor morphological features: concordant (22 patients), disconcordant (8); degree of circumferential bowel wall involvement: concordant (28), disconcordant (2); and longitudinal extent of the tumor: concordant (14), disconcordant (3), and undefined by EC (13). CONCLUSIONS: The images obtained by CTVE in colonic carcinoma are similar to those obtained by EC. CTVE is an excellent alternative to EC for patients who cannot tolerate EC and for cases with incomplete EC.

Adult↗
PubMed2002

[Analysis of the results of 1221 colonoscopies in the hospitals of Burkina Faso, 1994-1997].

The authors report the results of 1221 colonoscopies. It appears from their analysis that whereas functional diseases of the colon remain predominant and topical, organic diseases appear to be increasing in frequency (polyps, polyposis, rectocolic cancer, parasitical colitis, diverticulis). Inflammatory bowel diseases are also beginning to be seen. The reported cases of Crohn's disease and ulcerative colitis are, so far as they know, the first in their country.

Burkina Faso↗