Rainsbury R M, Lallemand R C
Frimley Park Hospital, Surrey.
Ann R Coll Surg Engl. 1988 Mar;70(2):80-4.
Patients presenting to a district general hospital (DGH) with colorectal neoplasms have been studied before and after the introduction of a colonoscopy service, in order to investigate the diagnostic, therapeutic and economic benefits of performing colonoscopy in preference to sigmoidoscopy and double contrast barium enema (DCBE). Colonoscopy led to a 3-fold increase in the incidence of colonic polyps, and 22% of all adenomas showed worrying features. Severe dysplasia and malignancy was seen most frequently in large adenomas (greater than 2 cm), and in those with a villous component. Laparotomy was avoided in 31 patients with proximal polyps, giving colonoscopy an added therapeutic and economic advantage over sigmoidoscopy and DCBE. Colonoscopy was used less frequently to detect colonic carcinomas, as over half of these were rectal, or presented as emergencies. These findings confirm the value of performing colonoscopy in patients who present with colorectal symptoms.
为了研究相比于乙状结肠镜检查和双重对比钡灌肠（DCBE），进行结肠镜检查在诊断、治疗和经济方面的益处，我们对一家地区综合医院（DGH）中患有结直肠肿瘤的患者在引入结肠镜检查服务前后进行了研究。结肠镜检查使结肠息肉的发病率增加了3倍，所有腺瘤中有22%表现出令人担忧的特征。严重发育异常和恶性肿瘤最常见于大腺瘤（大于2厘米）以及具有绒毛成分的腺瘤中。31例近端息肉患者避免了开腹手术，这使得结肠镜检查相对于乙状结肠镜检查和DCBE具有额外的治疗和经济优势。结肠镜检查较少用于检测结肠癌，因为其中一半以上是直肠癌，或者表现为急症。这些发现证实了对有结直肠症状的患者进行结肠镜检查的价值。
