Department of Surgery, Royal Hallamshire Hospital, Sheffield, UK, University of Sheffield, Sheffield, UK.
Colorectal Dis. 2000 Jan;2(1):41-4. doi: 10.1046/j.1463-1318.2000.00091.x.
There are concerns that the left colon may be incompletely examined by the standard 60-cm flexible sigmoidoscope. Our objective was to compare the endoscopist's assessment of the length of colon seen with the actual length visualized.
During flexible sigmoidoscopy, endoscopists were asked to state how far they had reached. This was compared with the length of colon actually seen, assessed by a novel electromagnetic imaging (EMI) device that records the three-dimensional position of the scope within a magnetic field pervading the patient's abdomen. If EMI showed that the splenic flexure had not been reached, the endoscopist was asked to use the imager to see if it helped advance the scope further.
In 94 patients, the endoscopist's assessment of position reached was correct in only 47 cases (50%), with an overestimate of length of colon visualized in 24 (25.5%) and an underestimate in 23 (24.5%). EMI showed the splenic flexure had not been reached in 56 patients (59.6%). Using information from the EMI system, further progress was subsequently made in 45/56 (80.4%).
Caution is required in the diagnosis of rectal bleeding using flexible sigmoidoscopy alone. This has implications for the use of the 60-cm flexible sigmoidoscope as a screening tool.
人们担心标准的 60 厘米乙状结肠镜可能无法完全检查左半结肠。我们的目的是比较内镜医生评估所见结肠长度与实际可视长度。
在进行乙状结肠镜检查时，要求内镜医生报告他们到达的距离。这与通过新型电磁成像（EMI）设备评估实际可见结肠长度进行比较，该设备记录了在弥漫患者腹部的磁场中，内镜的三维位置。如果 EMI 显示未到达脾曲，要求内镜医生使用成像仪检查是否有助于进一步推进内镜。
在 94 例患者中，内镜医生对到达位置的评估仅在 47 例（50%）中正确，24 例（25.5%）高估了可见结肠长度，23 例（24.5%）低估了可见结肠长度。56 例（59.6%）患者的 EMI 显示未到达脾曲。随后，根据 EMI 系统的信息，在 45/56（80.4%）例中进一步推进。
单独使用乙状结肠镜诊断直肠出血时需要谨慎。这对 60 厘米乙状结肠镜作为筛查工具的使用有影响。
