The management of suspected tumours of the colon: the role of colonoscopy in general surgery.

The role of colonoscopy in the management of 100 cases of suspected large bowel tumour is described. Forty out of 47 patients with an equivocal barium enema examination were satisfactorily examined and the possibility of a tumour being present was either confirmed or refuted. Examination of 30 patients with otherwise unexplained blood loss from the bowel revealed the cause in 50 per cent of them. Twenty-nine patients had pedunculated polyps which were snared and removed, thus avoiding laparotomy and colotomy. The problem of distinguishing tumours from other lesions or retained faeces by radiology arises most often in the sigmoid colon. This segment is easily examined using a short flexible endoscope. General surgeons taking up colonoscopy will find a 1-m single-channel instrument convenient to use and capable of reaching approximately 90 per cent of colonic tumours that require further investigation or endoscopic resection. Facilities for the examination of the whole colon should be available in established endoscopy units.