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[Sigmoidoscopy].

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Contraindications↗

[Endoscopic laser treatment of neoplasm and tubulovillous adenoma of the rectosigmoid. Initial experiences and review of the literature].

With laser it's possible to produce a radiation of definite wave length which is rich in energy. This energy is changed into heat during its impinge on tissue. Different effects (coagulation, vaporization) can be produced in dependence on wave length, the technical features of laser and the different interaction of laser light. In 8 patients with obstructive polypous carcinomas of rectosigmoid a complete passage-recovery could be achieved. The therapy was effective in 8 out of 11 patients with villous adenomas. One patient had a relapse into adenoma after half a year. With laser a distal rectostenosis at high degree could be widened at Morbus Crohn. Complications didn't appear. Indications of laser-therapy are explained. The laser-therapy is effective, not very risky but not cheap. Therefore it requires an application of overlapping subjects.

Adult↗

[Experiences with endoscopic recanalization using the Nd-YAG laser in tumor ileus and inoperable rectal cancer].

In the time period from January 1, 1987 until October 1, 1988, a total of 17 patients with an advanced colorectal tumor underwent transendoscopic laser treatment with the Nd-YAG laser. Eight patients had a tumor-dependent passage disorder with a large intestinal ileus as initial finding. Recanalisation and decompression of the intestine were successfully performed in 7 cases, so that placement of an anus praeternaturalis could be avoided. In another 8 patients the advanced rectal tumors were subjected to laser irradiation, 6 times because of subtotal stenosis and 3 times because of tumor bleeding. A locoregional radiatio (afterloading) was performed in each case.

Aged↗

[Rectoromanoscopic correction of sigmoid volvulus].

The volvulus of the sigma is about 40% of all cases with colonic ileus. It is seen in men three times more frequently than in women and affects men in advanced and elderly age. Since 1985 in the Emergency Medical Aid Institute "N. Pirogov" an instrumental method is applied for the treatment of volvulus of the sigma, namely rectosigmoidal intubation under the control of the rectoscopic tube. In 15 cases the manipulation was successful, the volvulus was reversed and the patients were pulled out of the grave ileus condition. The clinical picture of the volvulus of the sigma is classic. The instrumental method can be applied only to patients without gata for an acute condition in the abdomen requiring immediate emergency operation. The instrumental treatment of the volvulus of the sigma prevents surgical interventions under unfavourable conditions for the patient. In elderly patients it may be a lifesaving manipulation.

Acute Disease↗

Sensitive sigmoidoscopy: a straight sigmoid technique.

Colorectal cancer prevention requires screening more sensitive than standard colonoscopy in cost, convenience, comfort, and safety, and it requires screening more sensitive epidemiologically than occult blood, radiography, or standard sigmoidoscopy to detect small polyps throughout the colon. Using a 65-cm videosigmoidoscope and no sedation, this family doctor reached the ascending colon (95 percent of polyps) in 81 percent of 78 private practice patients not having prior intraperitoneal surgery (compared with 57 percent of 35 patients with abdominal surgery), mostly by gentle scope rotation for many minutes at 12-20 cm insertion to gather folds and keep the sigmoid colon straight.

Adult↗

Rectal bleeding.

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Aged↗

The role of sigmoidoscopy and rectal biopsy in diagnosis and management of inflammatory bowel disease: personal experience.

Conventional sigmoidoscopy and rectal biopsy are very useful in the diagnosis, differential diagnosis, and management of inflammatory bowel disease. The rectal biopsy is particularly important in establishing the diagnosis of Crohn's disease when the rectal mucosa is grossly normal. The sigmoidoscopy and biopsy serve to assess the response to medical therapy in inflammatory bowel disease and are important adjuncts to colonoscopy in surveillance for dysplasia and carcinoma in patients with ulcerative colitis. Sigmoidoscopy is quick, requires no preparation, is cost effective, and the biopsies are extremely safe with the use of the cupped bronchoscopic forceps.

Biopsy↗