[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)
Yanes Lecuna
E
E
Servicio de Gastroenterología, Centro Médico Docente La Trinidad.
Bandres
D
D
Carvajal
A
A
Ruiz
R
R
D000367:Age Factors; D000368:Aged; D003111:Colonic Polyps / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D012737:Sex Factors; D012812:Sigmoidoscopy
Papel de la sigmoidoscopia flexible en la detección precoz de tumores recto-colónicos.