Winawer S J, Miller C, Lightdale C, Herbert E, Ephram R C, Gordon L, Miller D
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Cancer. 1987 Oct 15;60(8):1905-8. doi: 10.1002/1097-0142(19871015)60:8<1905::aid-cncr2820600839>3.0.co;2-k.
Sigmoidoscopy could aid in the control of large bowel cancer by early detection of the 55% of colorectal cancers that develop in the rectosigmoid and by the identification and eradication of significant rectosigmoid adenomas. Rigid sigmoidoscopy has had poor patient acceptance and therefore has not been successful. The present study is a prospective randomized trial to evaluate patient response to flexible as compared with rigid sigmoidoscopy. Patients reported significantly less discomfort (10.1% versus 29.7%), anxiety (9.8% versus 27.6%) and embarrassment (5.2% versus 12.8%) during flexible as compared with rigid sigmoidoscopy. Flexible sigmoidoscopy appears to have better patient acceptance than rigid sigmoidoscopy (P less than 0.01). This could enhance its value as a cancer-control instrument. This article addresses the feasibility of sigmoidoscopy. Its validity also needs to be addressed within the framework of a long-term trial, evaluating mortality for rectosigmoid cancer.
乙状结肠镜检查可通过早期发现55%发生于直肠乙状结肠的结直肠癌以及识别和根除显著的直肠乙状结肠腺瘤，来辅助控制大肠癌。硬式乙状结肠镜检查的患者接受度较差，因此未取得成功。本研究是一项前瞻性随机试验，旨在评估患者对可弯曲乙状结肠镜检查与硬式乙状结肠镜检查的反应。与硬式乙状结肠镜检查相比，患者在可弯曲乙状结肠镜检查期间报告的不适（10.1%对29.7%）、焦虑（9.8%对27.6%）和尴尬（5.2%对12.8%）明显更少。可弯曲乙状结肠镜检查的患者接受度似乎优于硬式乙状结肠镜检查（P小于0.01）。这可能会提高其作为癌症控制工具的价值。本文探讨了乙状结肠镜检查的可行性。其有效性还需要在长期试验的框架内进行探讨，评估直肠乙状结肠癌的死亡率。
