[Role of coloscopy in diagnosis and treatment of large bowel diseases]

Abstract

Coloscopy is the most accurate method of evaluation of the whole large bowel. The main indications for this examination are doubtful radiological changes in the colon and unexplained intestinal symptoms, bleeding in the first place. Coloscopy plays also an important role in the differential diagnosis of colitis and in the oncological follow-up of patients after polypectomy or with long-standing ulcerative colitis. The therapeutic use of coloscopy includes removal of polyps and foreign bodies, control of bleeding, and laser photocoagulation of neoplasmatic lesions. Since 1973 in the Department of Gastroenterology of the Postgraduate Medical Center 2360 diagnostic coloscopies were carried out in 1838 patients. The most frequent diagnoses were polyps (34%) and large bowel cancer (12%). Various forms of colitis were diagnosed in 7% of patients, and all other diseases jointly in 11% of cases. In 36% of patients the large bowel showed no changes, in spite of undoubtful indications for coloscopy. Many of these patients were spared explorative laparotomy. By means of diathermic loop 808 colorectal polyps were removed in 421 patients. Rare complications of this procedure were bleedings (1.5%) and peritoneal irritation symptoms without perforation (0.25%). Adeneomas prevailed among polyps. Seventeen patients with invasive cancer in adenoma were treated successfully only endoscopically.