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At least 19 recordsLinked to original sources

PubMed1979

Comparison of flexible sigmoidoscopy with other diagnostic techniques in the diagnosis of rectocolon neoplasia.

Flexible sigmoidoscopy was compared to rigid sigmoidoscopy in the detection of colorectal neoplasia in a select group of patients. A distance of 30 cm or greater was obtained by flexible sigmoidoscopy in 94% of patients and a distance of 50 cm or greater in 46% of patients. A significant number of cancers and adenomas detected by flexible sigmoidoscopy were not detected by rigid sigmoidoscopy. Flexible sigmoidoscopy was tolerated better than rigid sigmoidoscopy but required twice the time. Flexible sigmoidoscopy could be combined with air-contrast barium enema the same day with the one preparation and did not interfere with the x-ray examination. All cancers and a significant number of adenomas detected subsequently on colonoscopy were detected by the combination of flexible sigmoidoscopy and air-contrast barium enema. Although the combination of flexible sigmoidoscopy and air-contrast barium enema is not adequate for thorough diagnostic evaluation of patients with a positive screening test, it may be of value in other select clinical situations. Flexible sigmoidoscopy has the potential for higher yield and better patient tolerance as compared to rigid sigmoidoscopy. This warrants further evaluation.

Adenoma↗

PubMed1977

Fiberoptic pansigmoidoscopy. An evaluation and comparison with rigid sigmoidoscopy.

A flexible 60-cm fiberoptic sigmoidoscope was evaluated in 139 patients. In 120 patients flexible sigmoidoscopy was compared with routine rigid sigmoidoscopy with respect to patient tolerance, distance of inspection, procedure time, and diagnostic yield. All patients were prepared with a single cleansing enema, and given no analgesia. Despite the fact that the flexible instrument was inserted nearly 3 times as far into the colon (55 cm versus 20 cm), more patients preferred the flexible examination. Significant pathological lesions were discovered by the flexible examination in 39% of patients, whereas rigid sigmoidoscopy discovered lesions in only 13%. Fluoroscopy performed during flexible sigmoidoscopy in 19 additional patients revealed that the instrument tip had reached the descending colon or beyond in 84% of patients. There were no complications. The flexible fiberoptic pansigmoidoscope offers promise as a practical diagnostic tool for a rapid and complete examination in patients with suspected colorectal diseases.

Adolescent↗

PubMed1979

Value of sigmoidoscopy and biopsy in detection of carcinoma and premalignant change in ulcerative colitis.

Of 111 carcinomas developing in 73 patients with ulcerative colitis, 46 (41.5%) arose in the rectum where they are directly accessible to sigmoidoscopy. Fifty-eight per cent of single carcinomas developed in the rectum. The extent and frequency of rectal dysplasia was assessed by examining slides of rectal mucosa with an eyepiece micrometer. Slides from 46 patients with carcinoma and 22 patients with dysplasia but no carcinoma in whom proctectomy or proctocolectomy had been carried out were examined by this method. Thirteen of 15 patients with carcinoma of the colon (87%) and 21/22 patients (95%) with large bowel dysplasia showed evidence only of rectal dysplasia. However, there was marked variability in the proportion of dysplastic rectal mucosa even in those patients with rectal carcinoma, while in some patients dysplasia was limited to a small focus. Because of the possibility of false negative biopsies due to sampling error, multiple biopsies should be taken to detect dysplasia. Their state should be recorded and deliberately varied at subsequent visits. Careful sigmoidoscopy and multiple biopsies in this study had potential value as an aid in the detection of 85-90% of all carcinomas. In practice the figure would almost certainly be lower due to intrinsic bias (see discussion) so that, although regular sigmoidoscopy and biopsy would be of great value when colonoscopy is not available, the latter should be included in any long-term programme of carcinoma prevention.

Biopsy↗

PubMed1975

Results of routine preoperative sigmoidoscopy and barium enema on patients with inguinal hernia.

The diagnostic findings of history, physical examination, rectal examination, barium enema, and sigmoidoscopy in 684 patients with the initial complaint of inguinal hernia were examined. History and physical examination led to the diagnosis of four cancers of the colon and one villous adenoma. No significant new findings were made by sigmoidoscopy when symptoms elicited by history did not indicate some abnormality. A cost analysis of finding significant disease in these patients with inguinal hernias indicates that in-hospital evaluation by barium enema and sigmoidoscopy is probably not warranted.

Adolescent↗

PubMedDate not supplied

[Role of flexible sigmoidoscopy in the early detection of colorectal tumors].

In a large endoscopic population screening study for colo-rectal polyps and cancer among 2,080 average-risk asymptomatic or with minor GI symptoms, adults of both sex, average age 56.2, were submitted to flexible sigmoidoscopy 60 cm as part of a preventive medical checkup. Procedure was very effective: 349 polyps were detected in 276 patients, with a total polyp incidence of 13.3%. In 174, more than 60% of such cases, endoscopic polypectomy was performed: 118 were tubular benign adenomas, 57 hyperplastic, 7 mixed types adenomas, 3 carcinomas in situ Dukes A, 2 villous adenomas one of them malignant, one leiomyoma and one rectal carcinoid. All in situ malignant polyps were removed endoscopically with excellent results. There was a high incidence of polyps (13.04%) in group aged 40-49, therefore changes on criteria for initiating routine flexible sigmoidoscopy must be considered. FOB tests (guaiac) showed a very low specific rate for diagnosis since only 24 out of 276 polyps bearing patients showed positive results, probably due to the fact that most polyps were non-ulcerating and small lesions. One third of the total polyps were out of the reach of the rigid scope and this procedure should be excluded in all screening programs of this type. Endoscopic polypectomy should be always an early procedure. In order to decrease the number of nondetected right side colonic lesions, non accessible to the 60 cm flexible scope, at time of polypectomy a simultaneous colonoscopy should be performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed1978

Sigmoidoscopy as a periodic screening test.

Available data suggest that routine screening procedures and removal of benign adenomatous polyps in all asymptomatic patients over the age of 40 to 50 years may significantly reduce both mortality and morbidity rates for colorectal carcinoma. Such data show that sigmoidoscopy is a valuable part of any screening program and can be performed at low cost and with minimal risk to the patient. It is concluded that an adequate routine screening program can be achieved with annual stool guaiac examination and sigmoidoscopy every five years between ages 40 and 50, and every three years over the age of 50 in asymptomatic patients. All patients with a history of colonic lesions must be seen more frequently because of the higher risk of recurrence.

Adult↗

PubMedDate not supplied

Fibre-optic sigmoidoscopy compared with the Kato technique in diagnosis and evaluation of the intensity of Schistosoma mansoni infection.

450 patients in Riyadh, Saudi Arabia, complaining of chronic abdominal pain and, coming from different countries endemic for schistosomiasis, were examined endoscopically using fibre-optic colono- or sigmoidoscopes, and rectal biopsies were examined for Schistosoma mansoni ova. After a preliminary study showed that more than 6 biopsies did not increase the positivity rate, 6 biopsies were taken from the rectum and examined by transparency technique. 280 were positive for S. mansoni, 9 of them having in addition S. haematobium. 4 patients had polyps in the sigmoid colon and rectum. When these positive cases were examined using duplicate 50 mg Kato smears, only 160 (57.1%) were positive. There was a highly positive correlation between the intensity of infection as graded by the 2 techniques. We recommend examination of 6 rectal biopsies using fibre-optic sigmoidoscopy when available in small communities with a patchy distribution of schistosomiasis like Saudi Arabia. The method could also be used to exclude schistosomiasis in persons who have moved from rural to urban or non-endemic areas and are unlikely to be re-exposed to infection.

Adolescent↗

PubMed1979