Knox Lyndee, Hahn Ricardo G, Lane Christianne
Department of Family Medicine, University of Southern California, Los Angeles 90033, USA.
J Am Board Fam Med. 2007 Sep-Oct;20(5):444-50. doi: 10.3122/jabfm.2007.05.060175.
Colonoscopy visualizes more of the colon than flexible sigmoidoscopy. This study compares the outcomes of an unsedated modified colon endoscopy (MCE) with flexible sigmoidoscopy (FS) in family medicine practice.
We conducted a retrospective chart review of existing clinical data to compare outcomes for 48 patients undergoing MCE and 35 patients undergoing FS at 3 family medicine practices in Los Angeles. Outcomes of interest included completion rates, number of complications, depth reached, anatomic site visualized, and information about the number and nature of clinical findings.
No significant differences were found between MCE and FS regarding completion rates (83.3% vs 75%, respectively). Expected statistically significant differences were found between the 2 procedures in the anatomic site visualized (P<.01) and depth reached (P<.01). Clinical pathologies were identified in 58% of MCE patients and 37% of FS patients. Four adenocarcinomas were identified in the MCE group in the proximal region of the colon that could not have been detected by FS.
Findings from this study suggest that MCE can be an acceptable alternative to FS in office settings for colorectal cancer screening.
结肠镜检查比乙状结肠镜检查能观察到更多的结肠部位。本研究比较了在家庭医学实践中，非镇静改良结肠镜检查（MCE）与乙状结肠镜检查（FS）的结果。
我们对现有临床数据进行了回顾性图表审查，以比较洛杉矶3家家庭医学诊所中48例行MCE的患者和35例行FS的患者的结果。感兴趣的结果包括完成率、并发症数量、到达深度、观察到的解剖部位以及有关临床发现的数量和性质的信息。
MCE和FS在完成率方面无显著差异（分别为83.3%和75%）。在观察到的解剖部位（P<0.01）和到达深度（P<0.01）方面，两种检查方法存在预期的统计学显著差异。58%的MCE患者和37%的FS患者发现了临床病变。MCE组在结肠近端区域发现了4例FS无法检测到的腺癌。
本研究结果表明，在门诊环境中，MCE可作为FS用于结直肠癌筛查的可接受替代方法。
