Author/Editor		Stefanovič, Milan
Title		The use of oesophagogastroduodenoscope for exclusion of synchronous cancer in patients with a diagnosed stenosing colorectal cancer
Translated title		Endoskopska izključitev sinhronega karcinoma ob že ugotovljenem distalnem stenozantnem kolorektalnem karcinomu s pomočjo ezofagogastroduodenoskopa
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 9, št. 22
Publication year		2004
Volume		str. 11-7
Language		eng
Abstract		Background. Synchronous neoplastic lesions are frequently diagnosed in patients treated ,for colorectal cancer. It is desirable to exclude the presence of a synchronous neoplastic lesion, especially of a cancer; prior to surgery in order to obviate the need for repeat operation. Patients and methods. Over the past two years, 5,578 colonoscopies have been performed in this Centre. The diagnosis of colorectal cancer was established in 119 cases. In 24 patients, complete colonoscopy using a colonoscope was not possible because of bowel obstruction due to a distal stenosing colorectal cancer. In four patients, the examination was continued with an oesophagogastroduodenoscope, and in all of them (100%) complete colonoscopy was accomplished preoperatively. Postoperative colonoscopic surveillance revealed a synchronous proximal neoplasm in two cases: a synchronous cancer in one, and a synchronous severely dysplastic adenoma in another. Repeat surgery was required in both patients. Conclusion. In view of a high rate of synchronous rneoplasms, we strongly recommend complete preoperative colonoscopy in all patients with colorectal cancer The use of oesophagogastroduodenoscope for complete colonoscopic examination of patients with malignant distal stenosis should be given priority over other alternative screening diagnostic methods.
Summary		lzhodišče. Sinhrone neoplazme so pogosta ugotovitev pri bolnikih, ki jih zdravimo zaradi kolorektalnega karcinoma. Zaželeno je, da že pred posegom izključimo sinhrono neoplazmo, predvsem karcinom, in se na ta način izognemo ponovni operaciji. Bolniki in metode. V dveletnem obdobju smo opravili 5578 koloskopij. Ugotovili smo 119 koloektalnih karcinomov. Pri 24 bolnikih, totalne koloskopije s koloskopom ni bilo moč opraviti zaradi neprehodnosti distalnega, stenozantnega kolorektalnega karcinoma. Od 4 bolnikov, pri katerih smo preiskavo nadaljevali z ezofagogastroskopom, smo pni vseh (100%) opravili predoperativno totalno koloskopijo. Ob pooperativni endoskopski kontroli smo pri dveh bolnikih ugotovili sinhrono proksimalno ležečo neoplazmo. Sinhroni karcinom pri enemu in sinhroni adenom s hudo stopnjo displazije pri drugemu. Pri obeh je bila potrebna ponovna operacija. Zaključek. Glede na pogostnost sinhronih neoplazem, menimo, da je nujno potrebno opraviti preoperativni pregled celotnega kolona. Uporaba ezofagogastroskopa omogoča totalno koloskopijo pri distalni maligni stenozi in ima prednost pred drugimi alternativnimi slikovnimi diagnostičnimi metodami.
Descriptors		COLORECTAL NEOPLASMS ESOPHAGOSCOPY GASTROSCOPY DUODENOSCOPY INTESTINAL OBSTRUCTION