Preoperative cytologic brushing and biopsy under direct Vision withfiberoptic colonoscopy(FC)and postoperative histopathologic examination wereperformed in 147 patients who were suspected of suffering from carcinoma o...Preoperative cytologic brushing and biopsy under direct Vision withfiberoptic colonoscopy(FC)and postoperative histopathologic examination wereperformed in 147 patients who were suspected of suffering from carcinoma of co-lon.In FC cytologic brushing,128 cases were positive for malignancy(87.1percent),18 false-negative(12.2 percent)and only one false-positive(0.7 percent).In the 146 FC biopsy specimens,124 were positive for malignancy(84 4 percent)and 22 false-negative and no false-positive.Combination of FC cytologic brushingwith FC biopsy could raise the diagnostic rate of colonic carcinoma to 95.2% anddecrease false-negative and false-positive because the two methods may replenisheach other in sampling and observation.Cytologic brushing is most valuable tothe early diagnosis of colonic carcinoma.When colonic stricture and obstructionprevent the colonoscope from reaching the lesion and FC biopsy cannot bedone,FC cytologic brushing is an effective method for diagnosis.The positiverate and false-negative rate of the cytologic brushing did not correlate to grosstyping,histopathologic typing and Dukes staging(P】0.05).The factorsinfluencing the correct diagnosis of colonic carcinoma by FC cytologic brushingare discussed in this paper.展开更多
Objective To assess the clinical values of computed tomographic colonography （CTC） in diagnosis of colonic polyps. Methods Forty-two patients who were clinically suspicious of colonic polyps or underwent colonic po...Objective To assess the clinical values of computed tomographic colonography （CTC） in diagnosis of colonic polyps. Methods Forty-two patients who were clinically suspicious of colonic polyps or underwent colonic polyps screening received examinations with both CTC and conventional colonoscopy. Sixteen- or 64-slice spiral computed tomography and professional imaging processing techniques were used for evaluation. Per-polyp and per-patient results were analyzed. Those by per-polyp were subsequently divided into ≥10 mm group, 5-10 mm group, and ≤5 mm group. Sensitivity, positive predictive value （PPV）, specificity, negative predictive value （NPV）, and accuracy were calculated using statistical method for diagnostic studies, with conventional colonoscopy as a gold standard. Results Ninety and 61 polyps were found by CTC and conventional colonoscopy, respectively. The per-polyp sensitivity/PPV were 80.3%/55.6% in total, and 100%/92.9%, 93.8%/65.2%, and 68.8%/ 41.5% in the ≥10 mm group, 5-10 mm group, and ≤5 turn group, respectively. The per-patient sensitivity, PPV, specificity, NPV, and accuracy were 97.1%, 89.5%, 42.9%, 75.0%, and 88.1%, respectively. Conclusion CTC can clearly reveal the morphology of colonic polyps and be used as a routine monitoring method for the clinical diagnosis of polyps.展开更多
To prevent complications, methods of inserting the colonoscope and intraor extra-intestinal factors that influence insertion were studied. Methods: After entering the sigmoid to 10 cm, the shaft of the scope should be...To prevent complications, methods of inserting the colonoscope and intraor extra-intestinal factors that influence insertion were studied. Methods: After entering the sigmoid to 10 cm, the shaft of the scope should be gradually straightened. The scope shouldn’t be advanced continuously though the lumen is obvious, otherwise, a loop may be formed and to straighten the shaft will be difficult. The patients who underwent colonoscopy before laparotomy were followed up to investigate the reasons of difficulties in insertion. For the patients who have several lumens after side-to-end anastomosis, the normal pathway is identified according to the direction of stool fluid and characteristics of large and small intestinal mucosas, and the colonoscope is prevented from entering the blind bottom. Results: In 10 000 colonoscopies, success rate o f reaching the cecum was 98. 8% and there were no complications. Conclusion: The speed of insertion, the success rate in colonoscopy and complications prevention will be improved if the manifestation of anatomic variations and difficulties in inserting scope are concerned.展开更多
文摘Preoperative cytologic brushing and biopsy under direct Vision withfiberoptic colonoscopy(FC)and postoperative histopathologic examination wereperformed in 147 patients who were suspected of suffering from carcinoma of co-lon.In FC cytologic brushing,128 cases were positive for malignancy(87.1percent),18 false-negative(12.2 percent)and only one false-positive(0.7 percent).In the 146 FC biopsy specimens,124 were positive for malignancy(84 4 percent)and 22 false-negative and no false-positive.Combination of FC cytologic brushingwith FC biopsy could raise the diagnostic rate of colonic carcinoma to 95.2% anddecrease false-negative and false-positive because the two methods may replenisheach other in sampling and observation.Cytologic brushing is most valuable tothe early diagnosis of colonic carcinoma.When colonic stricture and obstructionprevent the colonoscope from reaching the lesion and FC biopsy cannot bedone,FC cytologic brushing is an effective method for diagnosis.The positiverate and false-negative rate of the cytologic brushing did not correlate to grosstyping,histopathologic typing and Dukes staging(P】0.05).The factorsinfluencing the correct diagnosis of colonic carcinoma by FC cytologic brushingare discussed in this paper.
文摘Objective To assess the clinical values of computed tomographic colonography （CTC） in diagnosis of colonic polyps. Methods Forty-two patients who were clinically suspicious of colonic polyps or underwent colonic polyps screening received examinations with both CTC and conventional colonoscopy. Sixteen- or 64-slice spiral computed tomography and professional imaging processing techniques were used for evaluation. Per-polyp and per-patient results were analyzed. Those by per-polyp were subsequently divided into ≥10 mm group, 5-10 mm group, and ≤5 mm group. Sensitivity, positive predictive value （PPV）, specificity, negative predictive value （NPV）, and accuracy were calculated using statistical method for diagnostic studies, with conventional colonoscopy as a gold standard. Results Ninety and 61 polyps were found by CTC and conventional colonoscopy, respectively. The per-polyp sensitivity/PPV were 80.3%/55.6% in total, and 100%/92.9%, 93.8%/65.2%, and 68.8%/ 41.5% in the ≥10 mm group, 5-10 mm group, and ≤5 turn group, respectively. The per-patient sensitivity, PPV, specificity, NPV, and accuracy were 97.1%, 89.5%, 42.9%, 75.0%, and 88.1%, respectively. Conclusion CTC can clearly reveal the morphology of colonic polyps and be used as a routine monitoring method for the clinical diagnosis of polyps.
文摘To prevent complications, methods of inserting the colonoscope and intraor extra-intestinal factors that influence insertion were studied. Methods: After entering the sigmoid to 10 cm, the shaft of the scope should be gradually straightened. The scope shouldn’t be advanced continuously though the lumen is obvious, otherwise, a loop may be formed and to straighten the shaft will be difficult. The patients who underwent colonoscopy before laparotomy were followed up to investigate the reasons of difficulties in insertion. For the patients who have several lumens after side-to-end anastomosis, the normal pathway is identified according to the direction of stool fluid and characteristics of large and small intestinal mucosas, and the colonoscope is prevented from entering the blind bottom. Results: In 10 000 colonoscopies, success rate o f reaching the cecum was 98. 8% and there were no complications. Conclusion: The speed of insertion, the success rate in colonoscopy and complications prevention will be improved if the manifestation of anatomic variations and difficulties in inserting scope are concerned.
