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[1st experience with the use of a flexible fiber endoscope].

X-ray examinations as a basic method of recognizing pathological processes in the descending segments of the intestinal tract do not always make it possible to ascertain the nature of the affection. An effective diagnostic method is endoscopy that can be implemented with the help of the Soviet-made flexible fibre endoscope, model CBO-1. The device is reliable in operation, easy and convenient to handle and allows it to examine not only the sigmoid flexure, but the descending segment of the large intestine as well.

Adolescent↗
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Rigid rectosigmoidoscopy: still a well-tolerated diagnostic tool.

BACKGROUND: Although rigid rectosigmoidoscopy has been gradually replaced by the use of flexible rectosigmoidoscopy in recent years, it remains an effective, economic and widely available diagnostic tool. The aim of this study was to determine the type and magnitude of symptoms during rigid rectosigmodoscopy. METHODS: Prospective evaluation of patients who underwent diagnostic rigid rectosigmoidoscopy. The main complaints were recorded, and their magnitude quantified using a visual analogue scale. RESULTS: A total of 134 patients (mean age = 48 years) were examined. The prone jackknife position was used in 54% of them and left lateral decubitus in 46%. A complete (full length) examination was achieved in 68%. There were no complications. Sixty percent of patients referred complaints: pain (33%), discomfort by rectal preparation (13%), uncomfortable defecation desire (8%), and discomfort by the position (4%). Median values determined by visual analogue scale for pain, discomfort by rectal preparation, uncomfortable positioning and overall discomfort were graded as 3.3, 3.3, 2.1 and 2, respectively. There was an association between higher magnitude of pain and overall discomfort with female gender, left lateral decubitus position, and full-length exploration (p < 0.05). CONCLUSION: A high percentage of patients have symptoms during rigid rectosigmoidoscopy but the study is usually well tolerated due the low magnitude of pain and discomfort and remains a very cost-effective study.

Female↗
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Flexible sigmoidoscopy as a screening test for colorectal cancer.

Flexible sigmoidoscopy (FS) is one of the screening modalities for colorectal cancer. The rationale for screening with flexible sigmoidoscopy is that it provides direct visualisation of the colon, and suspicious lesions can be biopsied. The most obvious disadvantage is that it examines only the lower third of the colon. The technical aspects of FS are sufficiently clear to enable us to define what FS can and cannot do. From the point of view of screening, FS clearly cannot completely exclude the presence of colon cancer in all asymptomatic people. A distinction must be made between screening the general population and testing the individual seeking screening. For the former, obtaining the greatest mortality benefit safely and at an acceptable cost to the nation is the crux of the matter. Recently published data indicate that FS is a cost-effective screening strategy, although colonoscopy and annual fecal occult blood test avert a greater number of cancer deaths. The results of randomised controlled trials of screening FS and colonoscopy, currently being conducted, will allow us to make a more accurate comparison with the established data regarding fecal occult blood test. In conclusion, flexible sigmoidoscopy every 5 years with or without FOBT is one of the screening methods recommended by major professional organizations. It identifies 50 to 70% of the advanced neoplasms, if any discovery of a distal neoplasia is followed up with a total examination of the colon by colonoscopy.

Age Factors↗