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首页> 外文期刊>Surgical Endoscopy >Sensitivity of double contrast barium enema and colonoscopy for the detection of colorectal neoplasms.
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Sensitivity of double contrast barium enema and colonoscopy for the detection of colorectal neoplasms.

机译：双对比钡灌肠和结肠镜检查对检测大肠肿瘤的敏感性。

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BACKGROUND: Double contrast barium enema (DCBE) is the examination carried out most frequently for investigation of patients with large bowel symptoms. The aim of this study was to compare the sensitivity of DCBE and colonoscopy for the detection of colorectal cancer and neoplastic polyps >/= 1 cm. METHODS: All patients undergoing DCBE (1389) or colonoscopy (1081) as the primary investigation for large bowel symptoms or for cancer or polyp surveillance in the first 9 months of 1997 at a large teaching hospital were included in this study. At 1 and 2 years following investigation, a computerized search of appropriate diagnosis and procedure codes to detect any missed cancers or polyps was performed for all patients with a normal investigation. RESULTS: Almost 19% of patients in both groups went on to have an additional large bowel investigation over the 2-year period. In the DCBE group, 47 patients (3.5%) had a cancer diagnosed; eight of them had been missed at the primary investigation (sensitivity 83%). In the colonoscopy group, 37 patients (3.4%) had a cancer; one of them had been missed at the primary investigation (sensitivity 97.5%). Neoplastic polyps >/= 1 cm were diagnosed in 1.6% of the DCBE group and in 7.7% of the colonoscopy group, with sensitivities of 21.7% and 91.4%, respectively. Nine patients (0.6%) had a false positive diagnosis of cancer in the DCBE group; one had an iatrogenic bowel perforation following flexible sigmoidoscopy. CONCLUSIONS: Where adequate facilities and expertise exist, colonoscopy should be the investigation of choice for most patients with large bowel symptoms suggestive of neoplastic disease.
机译：背景：双对比钡灌肠（DCBE）是检查大肠症状患者最常进行的检查。这项研究的目的是比较DCBE和结肠镜检查对检测结直肠癌和> / = 1 cm的息肉的敏感性。方法：所有纳入DCBE（1389）或结肠镜检查（1081）作为大肠症状或癌症或息肉监视的主要研究对象的患者均于1997年头9个月在大型教学医院接受此项研究。在调查后的第1年和第2年，对所有检查正常的患者进行了计算机搜索，以查找适当的诊断和程序代码，以检测是否遗漏了任何癌症或息肉。结果：两组中近19％的患者在2年内继续进行了大肠检查。在DCBE组中，有47名患者（3.5％）被诊断出患有癌症;其中有八项在初次调查中被漏诊（敏感性83％）。在结肠镜检查组中，有37名患者（3.4％）患有癌症;其中一项在初次调查中被遗漏（敏感性97.5％）。在DCBE组中有1.6％在结肠镜检查组中诊断为> / = 1 cm的肿瘤性息肉，在结肠镜检查组中则诊断为7.7％，敏感性分别为21.7％和91.4％。 DCBE组中有9名患者（0.6％）的癌症诊断为假阳性;一个人在柔性乙状结肠镜检查后出现了医源性肠穿孔。结论：在有足够设施和专业知识的地方，结肠镜检查应作为大多数大肠症状提示肿瘤性疾病的患者的研究选择。

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