Britton D C, Tregoning D, Bone G, McKelvey S T
Br Med J. 1977 Jan 15;1(6054):149-51. doi: 10.1136/bmj.1.6054.149.
Colonoscopy is a rewarding new technique with a potential for early and more accurate diagnosis. One hundred and seventy colonoscopies carried out over the past three years showed or confirmed colonic cancer in 14 patients, and solitary or multiple colonic polyps were found in 28 cases, of which 18 were excised endoscopically. A large villous adenoma was diagnosed in one patient, and the absence of a suspected sinister lesion was shown by direct examination and biopsy in 110 cases. There were 17 examination failures, including two perforations of the bowel. Colonoscopy complements rather than supplants barium enema examination and will make diagnostic laparotomy for colonic lesions unnecessary. The use of the diathermy snare allows endoscopic removal of colonic polyps and should greatly reduce the need for formal surgery in these cases. The financial saving to the Health Service will greatly outweigh the expense of the procedure, but it should be undertaken only in well organised centres as a specialist service for selected patients. In skilled hands it is safe, but potential hazards exist for the inexperienced endoscopist.
结肠镜检查是一项很有价值的新技术，具有早期及更准确诊断的潜力。过去三年进行的170例结肠镜检查显示或确诊了14例结肠癌，发现28例有单个或多个结肠息肉，其中18例在内镜下切除。一名患者被诊断为大的绒毛状腺瘤，110例经直接检查和活检未发现可疑的恶性病变。有17例检查失败，包括两例肠穿孔。结肠镜检查是对钡灌肠检查的补充而非替代，将使结肠病变无需进行诊断性剖腹手术。使用透热圈套器可在内镜下切除结肠息肉，在这些病例中应能大大减少正规手术的需求。对国民医疗服务体系而言，节省的费用将大大超过该检查的成本，但仅应在组织完善的中心作为针对特定患者的专科服务开展。在技术熟练的人员操作下是安全的，但对于缺乏经验的内镜医师存在潜在风险。
