[Colonoscopy as a diagnostic and therapeutic method of the large bowel diseases: analysis of 2,567 exams].
BACKGROUND
Since the sixties, when the optic fibers were reported, colonoscopy had emerged as the first line imaging investigation of the colon.


OBJECTIVE
To review the results of diagnostic and therapeutic colonoscopy at the Discipline of Coloproctology of the University of São Paulo Medical School, São Paulo, SP, Brazil, respecting the characteristics of an institution of medical education.


METHODS
Retrospective analysis of basis related to 2,567 fibro colonoscopies between 1984 and 2002. The procedure was performed in hospitalized and in outpatients. The most common indications for colonoscopy were investigation of rectal bleeding and anemia (22.4%), change of bowel habit (14.76%), inflammatory bowel disease (8.65%) and carcinoma (7.25%). Bowel preparation with manitol was used by most of the patients. Sedation, when not contra-indicated, was administered. The most common combination was meperidine and benzodiazepine. All the exams were monitored with pulse oximeter. A normal colonoscopy to the point of maximum insertion was reported in 42.42% of procedures. The most common diagnosis was polyps (15.47%), followed by diverticular disease (12.86%). Inflammatory disease was recorded in 11.88% and carcinoma in 10.21%. Polypectomy was undertaken in 397 patients (2.21 polypectomy per patient with polyps). Colonoscopy was considered incomplete (when the colonoscope did not pass to the cecum or terminal ileum) in 181 (7.05%) cases. Perforation was reported in one patient who had a subestenosing retossigmoid tumor. In 0.42%, reasons for failing to complete the procedure included complication related to sedation, with no further prejudice for the patients.


CONCLUSIONS
Colonoscopic examination of the entire colon remains the standard for visualization, biopsy and treatment of colonic affections. The incidence of complication of endoscopy of the large bowel is quite low, even in a school hospital.
Nahas
Sergio Carlos
SC
Serviço de Coloproctologia, Hospital das Clínicas da Faculdade de Medicina de Universidade de São Paulo, SP.
Marques
Carlos Frederico Sparapan
CF
Araújo
Sérgio Alonso
SA
Aisaka
Adilson Akihide
AA
Nahas
Caio Sérgio Rizkallah
CS
Pinto
Rodrigo Ambar
RA
Kiss
Desidério Roberto
DR
D003113:Colonoscopy; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000601:surgery*; D007420:Intestine, Large; D012189:Retrospective Studies