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Results for “Colonoscopy”

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At least 919 records · Page 51Linked to original sources

PubMed2005

[Clinical investigation of total intravenous anesthesia with remifentanil and propofol for colonoscopy in the elderly].

OBJECTIVE: To evaluate the efficacy and safety of intravenous anesthesia with remifentanil and propofol for colonoscopy in the elderly. METHODS: Thirty old patients scheduled for colonoscopy were randomly allocated into remifentanil group and fentanyl group. Those in group remifentanil received remifentanil at the dose of 0.05 microg/kg.min with micropump, while those in group F were given a bolus injection of fentanyl at 1 microg/kg intravenously. One minute later, all the patients were given a loading dose of propofol of 0.4 mg/kg followed by boluses of propofol (0.2 mg/kg) administered intermittently until Ramsay sedation scale III-IV. The induction time of anesthesia, intubation time of colonoscope, time of recovery from anesthesia and stay in the postanesthesia care unit (PACU) were recorded. The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO(2)) and respiratory rate (RR) were measured and recorded with noninvasive monitoring. The lower limb movement, apnea, dizziness, body weakness, nausea and vomiting, and chest wall rigidity were recorded during operation. All the patients were reviewed for satisfaction after the operation. RESULTS: The time of anesthesia induction, intubation time of colonoscope, time of recovery from anesthesia and stay in PACU in remifentanil group were shorter than those in fentanyl group (P<0.05), and propofol consumption was significantly less in the former group (P<0.05). Greater MAP decrement was observed in remifentanil group (P<0.05). Fewer patients had lower limb movement while more had respiratory depression in remifentanil group than in fentanyl group. The rate of patient-rated satisfaction was significantly higher in remifentanil group (P<0.05). CONCLUSION: Intravenous anesthesia with remifentanil and propofol for colonoscopy is safe and reliable, which can be a good alternative for anesthesia in outpatient operation for the elderly.

Aged↗

PubMed2005

Colorectal cancer detection in a rural community. Development of a colonoscopy screening program.

PROBLEM BEING ADDRESSED: Colorectal cancer (CRC) is a substantial cause of death and morbidity in Canada. Endoscopy screening by colonoscopy has been recommended, but widespread implementation is impossible because it is difficult to obtain, especially in rural areas. OBJECTIVE OF PROGRAM: To screen for CRC safely and effectively using colonoscopy performed by non-specialist endoscopists in rural areas. PROGRAM DESCRIPTION: Health providers and community organizations were informed about the screening program. Patients between the ages of 50 and 75 and those at high risk of CRC based on family history were screened. Measures of safety and effectiveness were monitored. In 2 years of screening, one of 152 patients was found to have CRC, and 23.7% had adenomatous polyps. There were no complications. Rates of CRC and adenoma detection and cecal intubation were similar to rates found in other screening studies. CONCLUSION: It was not difficult to design and implement a CRC screening program in our small rural community. Colonoscopies performed by family physicians have been effective, and there have been no serious complications.

Aged↗

PubMed2005

[Clinical application of magnifying colonoscopy in diagnosis and treatment of colorectal benign neoplastic lesions].

OBJECTIVE: To evaluate the clinical value of magnifying endoscopy in diagnosis and treatment of colorectal benign neoplastic lesions. METHODS: Seventy-eight colorectal lesions in 61 patients were examined with magnifying colonoscopy after indigo carmine dyeingìand pit pattern diagnosis was made for every lesion according to Kudos classification to differentiate neoplastic lesions from non-neoplastic lesions. The lesions were resected by endoscopic polypectomy and mucosectomy or surgical treatment. The diagnoses made by magnifying colonoscopy were compared with pathologic results. RESULTS: The diagnostic sensitivity of magnifying endoscopy for neoplastic lesions was 98.4% and specificity was 85.7%. The overall accuracy for adenoma and early colorectal cancer was 96.2%. 89.7% of adenomatous lesions were treated by endoscopic resection. CONCLUSION: The magnifying colonoscopy can provide instantaneous and accurate diagnosis of neoplastic lesions in colon and rectum,as well as minimally invasive treatment.

Adult↗

PubMedDate not supplied

Listening to music decreases need for sedative medication during colonoscopy: a randomized, controlled trial.

BACKGROUND: Music played during endoscopic procedures may alleviate anxiety and improve patient acceptance of the procedure. A prospective randomized, controlled trial was undertaken to determine whether music decreases the requirement for midazolam during colonoscopy and makes the procedure more comfortable and acceptable. METHODS: Patients undergoing elective colonoscopy between October 2003 and February 2004 were randomized to either not listen to music (Group 1; n=40) or listen to music of their choice (Group 2; n=38) during the procedure. All patients received intravenous midazolam on demand in aliquots of 2 mg each. The dose of midazolam, duration of procedure, recovery time, pain and discomfort scores and willingness to undergo a repeat procedure using the same sedation protocol were compared. RESULTS: Patients in Group 2 received significantly less midazolam than those in Group 1 (p=0.007). The pain score was similar in the two groups, whereas discomfort score was lower in Group 2 (p=0.001). Patients in the two groups were equally likely to be willing for a repeat procedure. CONCLUSION: Listening to music during colonoscopy helps reduce the dose of sedative medications and decreases discomfort experienced during the procedure.

Adult↗

PubMed2006

Detection of colorectal lesions by using autofluorescence colonoscopy in acromegalics and their relation to serum growth hormone and insulin-like growth factor-1 levels.

OBJECTIVES: Acromegalics have an increased risk of colorectal neoplasm. The aim of this study was to establish the association between acromegaly and colorectal lesions. MATERIALS AND METHODS: The study included 51 patients with active acromegaly: 30 women and 21 men (average age 52.95 +/- 13.49 years). Growth hormone (GH), insulin-like growth factor I (IGF-I), prolactin (PRL), thyreothropin (TSH), thyroxine (FT4) were measured in the serum when patients were hospitalized for their first diagnosis of acromegaly, before starting the treatment. All patients underwent colonoscopy--in the first phase conventional in white light; in the second phase fluorescence colonoscopy. Autofluorescence of colonic mucosa was assessed by illumination with monochromatic light. Green fluorescence is characteristic for normal colonic mucose, whereas red fluorescence occur in pathological lesions. Material to histopathological examination was taken from every pathological colorectal lesion. RESULTS: Using conventional colonoscopy we detected colonic polyps in 21 acromegalic patients (41.17%). Polyps with red fluorescence were found in 7 (13.7%) acromegalics and with green fluorescence in 16 (31.37%) cases of these patients. Histological diagnoses of colorectal lesions are adenoma, hyperplastic and inflammatic polyps. The number of colorectal polyps was dependent on IGF-I, fT4 and sex. CONCLUSIONS: Acromegaly is associated with high prevalence of colorectal pathology, mainly hyperplastic polyp and adenoma. There is a relationship between number of colorectal polyps and serum IGF-I levels in acromegaly. Adenomas and hyperplastic polyps were associated with higher levels of IGF-I.

Acromegaly↗

PubMed1991

Is colonoscopy safe in the early postcolectomy period?

Colonoscopy was performed preoperatively and 1, 2, 3 and 7 days following a left hemicolectomy with a primary anastomosis in 11 dogs. The remaining colon and anastomosis were adequately visualized. Maximal intraluminal pressures achieved were from 15 to 35 mmHg. No leakage of air or intra-abdominal abscesses were present. In ten patients undergoing colonoscopy for lower gastrointestinal symptoms, the pressures were similarly measured. Although pressures were slightly higher in patients, averaging 30 mmHg, the results suggest that colonoscopy can be safely performed during the early postcolectomy period.

Air↗

PubMed1991

[Combination intestinal lavage: a conservative procedure for colonoscopy].

The purpose of this study was to optimize the cleaning for colonoscopy. We compared a combination of senna pods and Goleytely solution to the exclusive ingestion of 7 litres of Goleytely solution. Test parameters were the score of visual assessment in five regions of the large bowel, the distension of the abdomen, concentration of hydrogen and methane in intestinal gases and subjective informations about abdominal complaints. We concluded from 80 colonoscopies that the combined procedure was almost identical with the cleaning by voluminal ingestions of Goleytely solution. There were no differences in the scores of visual assessment or concerning the intestinal gases. The additional administration of simethicone resulted in a statistically significant decrease of foam production. Thus, the combination of senna pods, a reduced ingestion of Goleytely solution supplemented with simethicone can be recommended for colonoscopy.

Adult↗

PubMedDate not supplied

[Electrolyte solution with polyethylene glycol to cleanse the colon for colonoscopy or enema].

The efficacy and safety of an electrolyte-polyethylene glycol solution (SE-PEG) for colonic lavage, was compared with standard bowel preparation (SBP) in a randomized blinded study of volunteers and patients undergoing colonoscopy and barium enema examination. Side effects, biochemical and hematologic changes and quality of examinations were monitored. Colonoscopy and barium enema was scored by colonic segment for type of residual stool and percentage of bowel wall visualized. For colonoscopy and barium enema, preparation with SE-PEG allowed better visualization and produced more optimal exams (8 vs 3; p less than 0.03) and (6 vs 4; p = NS) respectively. We conclude that colonic lavage with SE-PEG is an alternative bowel preparation method and is cheaper, more safe and effective than SBP procedure.

Adult↗

PubMed1990

Colonoscopy in children with bleeding per rectum.

There are few reports of colonoscopy in children. Twenty-six children with bleeding per rectum were examined colonoscopically to determine the aetiology of the bleeding. A total of 32 colonoscopies were performed. Except for 5 children who needed general anaesthesia, all the rest were performed with pethidine and diazepam sedation. The mean age of these 26 children was 63.5 months (SD 57.5 months, range 2 weeks to 180 months). Ten children had histologically confirmed colitis. Five had bleeding juvenile polyps and these were removed endoscopically. One had lymphoid hyperplasia and one had chronic solitary sigmoid ulcer. The rest were normal. It is concluded that colonoscopy can be performed safely in children and it is a good diagnostic and therapeutic procedure.

Child, Preschool↗

PubMedDate not supplied

Arterial oxygen desaturation during ambulatory colonoscopy: predictability, incidence, and clinical insignificance.

Arterial hemoglobin oxygen saturation was prospectively monitored in 103 consecutive patients undergoing office colonoscopy to determine the incidence of any clinical characteristics which might predict arterial desaturation to less than 90%. Baseline saturations were obtained prior to premedications and continuously during the examination using a finger mounted pulse oximeter. Intravenous premedication regimens varied from none to a maximal dose of 50 mg of meperidine and 10 mg of diazepam. All colonoscopies included cecal intubation and were performed by one investigator employing a video colonoscope. The incidence of desaturation was 41% without significant variation among the sedation groups. Age was positively correlated with desaturation (p less than 0.05). Sex, obesity, history of lung or heart disease, chronic cardiac medications, and baseline saturation percentage failed to be sensitive predictors of desaturation. No parameter could be correlated with prolongation of desaturation below 90%. No adverse outcomes or complications were noted during the periendoscopy period, suggesting that oximetry monitoring during outpatient colonoscopy may not be clinically useful.

Adult↗

PubMedDate not supplied

[Colonoscopy as primary procedure in the diagnosis of colonic neoplasms].

Experience with colonoscopy as an initial procedure in the study of the colon is presented. 3.450 colonoscopies in patients with GI symptoms were performed by trained endoscopists using the intermediate length scopes (130cm) without fluoroscopy. In 90% of the cases the whole colon was studied in a mean time of 20 minutes. 382 neoplasms (11.07%) were diagnosed. Polips represented 90% of the lesions and 34.3% of them were adenomas. 30% of the adenomas and 34.4% of the malignant tumors were localized in the right colon. We emphasise that 82.7% of the polips found in the right colon were adenomas. As a side effect we had a sigmoid perforation, it represents 0.03%. Colonoscopies performed by a trained endoscopist is a highly diagnostic method with low degree of complications, making it the procedure of choice in the study of the colon in specialized centers.

Adenoma↗

PubMed1989

Colonoscopy in Jamaica--a 12-year experience.

Four hundred and nine colonoscopic examinations were performed in 335 patients over a 12-year period in Jamaica. The main indications were suspected polyps (34%) rectal bleeding (22%) and suspected carcinoma (11%). Total colonoscopy was performed in 33% of cases. The ascending colon and hepatic flexure were examined in a further 25%, and the transverse colon in another 21%. Endoscopic examination of the suspected abnormal area was possible in all cases. In 142 examinations, no abnormality was detected, reflecting a false positive Barium enema in some. Polyps were found in 135 examinations, diverticula in 69 and carcinoma in 13. There were no complications. Colonoscopy was more sensitive and specific than Barium enema. The Barium enema findings were incorrect in 91 of 224 examinations (41%). Colonoscopy is a safe and accurate procedure which enables improved patient management.

Adolescent↗

PubMed1989

[Recent problems in colonoscopy for the diagnosis of colorectal cancer].

Colonoscopy is valuable for the correct diagnosis of colorectal cancers and polyps, and it is widely utilized as the routine examination. One of our recent interests in colonoscopy has been how to diagnose minute lesions accurately. For the purpose, magnifying endoscopy using the magnifying colonoscope (type CF-HM and CF-UHM, Olympus), videoendoscopy, endoscopic ultrasonography, and so on, have been evaluated as a future colonoscopy.

Colonic Polyps↗

PubMed1989

Comparison of the value of emergency mesenteric angiography and intraoperative colonoscopy with antegrade colonic irrigation in massive rectal haemorrhage.

The investigation of massive rectal haemorrhage has routinely included emergency mesenteric angiography to identify the site of bleeding in preparation for surgery. Nine cases over 18 months were identified from the angiography register and reviewed retrospectively. Angiography demonstrated the bleeding point in only one case, rendering colonoscopy unnecessary. However, that patient became shocked, requiring six units of blood during angiography. A second patient suffered cardiac arrest during angiography. The mean time taken was 1 1/2 h constituting a considerable delay before proceeding to surgery. On-table colonoscopy with antegrade lavage showed the bleeding site in seven out of nine cases and the mean time for operation was 3 h. One patient stopped bleeding spontaneously and there was one postoperative death from an unrelated cause. We conclude that there is no place for emergency mesenteric angiography in massive acute large bowel haemorrhage and that early surgery with antegrade colonic lavage and on-table colonoscopy is the treatment of choice.

Acute Disease↗

PubMed1985

[Colonoscopy detection of polyps in patients operated on for colorectal cancer. Prospective study].

Subjects operated upon for colorectal carcinoma seem to constitute a population at high risk of a second colorectal malignancy and/or colonic adenoma (polyp). Ninety-four such patients were examined by colonoscopy. Their distribution by age and sex and the location of cancers in the colon were comparable to those reported in the literature. Colonoscopy was performed 12 +/- 6 months after surgery in 52 patients and was complete in 90% of them. Twenty-seven patients (52%) were found to have one or several polyps distributed throughout the colonic frame and varying in size from 2 to 75 mm (75% were less than 10 mm long). The larger the polyp, the more severe the dysplasia. Three malignant polyps were discovered; they were more than 10 mm in diameter. The colonoscopic examination was repeated annually over more than 3 years in 30 patients: at first repeat examination 54% had polyps which were still present in more than 30% at subsequent examinations. It is concluded that patients operated upon for colorectal carcinoma are at high risk of polyps and/or a second colorectal carcinoma and must therefore be followed-up by repeated colonoscopy.

Colonic Neoplasms↗

PubMed1988

Vascular ectasia. Diagnosis and treatment by colonoscopy.

Vascular ectasia is an increasingly recognized cause of gastrointestinal tract bleeding in the elderly. Colonoscopy is assuming an important role in diagnosis and treatment of these lesions. The records of 30 patients who had a diagnosis of vascular ectasia made by colonoscopy have been retrospectively reviewed. The 30 patients included 14 men and 16 women whose median age was 70 years (range, 54 to 89 years). All patients had vascular ectasia of the cecum or ascending colon or both, five patients (16.7%) had multiple lesions, and 18 patients (60%) had associated cardiac, vascular, pulmonary, or renal disease. Of the 27 patients who presented with gastrointestinal tract bleeding, 13 (48.1%) underwent endoscopic fulguration, nine (33.3%) underwent resection, and seven (25.9%) were treated conservatively. Endoscopic fulguration was definitive treatment in 11 of the 27 patients (40.7%). A positive histologic diagnosis of vascular ectasia was made in nine of 15 patients (60%) in whom endoscopic biopsy was performed. In the hands of an experienced endoscopist, colonoscopy is a safe and effective way of diagnosing vascular ectasia and is potentially therapeutic. Endoscopic coagulation should be attempted before operation in patients with chronic anemia, limited bleeding, or concomitant severe medical disease.

Aged↗

PubMed1987

Whole gut lavage for colonoscopy. A comparison between preparation at home or at the hospital.

The clinical efficiency and patient acceptability of peroral colonic lavage with a 3 liters balanced electrolyte solution (BES), when performed either at the hospital on the day of colonoscopy or during the preceding evening in the patient's home, was evaluated in 62 consecutive outpatients. No significant difference was found between adequacy of bowel preparation, when the lavage was performed in the patient's home or at the hospital. The bowel preparation was found to be satisfactory in 61% and 77% of the patients. The percentage of sufficient preparation was 60% of the patients, who were not able to drink 3 litres of BES within the 2-hours period. This study demonstrated that colonic lavage with BES could be performed equally well at home the day before colonoscopy as at the hospital on the day of colonoscopy. The relatively low rate of sufficient preparation was related to the fixed and small volume of BES ingested. To improve the adequacy of bowel preparation a graded intake of BES is suggested.

Administration, Oral↗

PubMed1987

Effect of bisacodyl on gut lavage cleansing for colonoscopy.

The effect of 10 mg oral bisacodyl (n = 19) or placebo (n = 26) on colon cleansing with polyethylene glycol electrolyte lavage solution was studied during colonoscopy. Patient tolerance was evaluated by questionnaire. During colonoscopy endoscopists graded adequacy of cleansing and subjective amounts of residual fluid and recorded the actual amount of fluid suctioned. Patient tolerance and adequacy of cleansing were not different between bisacodyl and placebo. There was no difference in subjective and measured residual fluid between the two groups. Compared to placebo, 10 mg oral bisacodyl does not influence adequacy of cleansing, patient tolerance, or residual fluid following polyethylene glycol electrolyte lavage solution for colonoscopy. This suggests that the beneficial cleansing effects with bisacodyl for barium enema may occur by mechanisms other than simple fluid evacuation.

Adolescent↗