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3.
Acta Gastroenterol Belg ; 83(4): 549-556, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33321010

RESUMO

Aim: Traditional serrated adenomas are the rarest member of the serrated polyps, that have endoscopic and morphologic similarities with conventional adenomas, tubulovillous adenomas, in particular. We aimed to compare the histopathologic and immunohistochemical features of TSAs showing overt dysplasia with conventional TVAs in a compartmental manner using digitalized images. Patients and methods: For 25 TSAs and 25 TVAs, extent of the morphologic features including cytoplasmic eosinophilia, mid-zonal nuclei, ECFs, slit-like serration, brush border, gastric foveolar-like epithelium and goblet cells were evaluated. Immunohistochemistry was perfomed using primary antibodies including CK7, CK20, MUC2, MUC5AC, MUC6, B-catenin, Ki67, p53, p16, MLH1, MSH2, MSH6 and PMS2. Results: Eosinophilic cells, mid-zonal nuclei, slit-like serration and ECF were significantly more extensive in TSAs compared to TVAs (p<0,001) while gastric epithelium was also more extensive in TSA cohort with a lower significance (p<0,01). Cut-offs for these features yielding the highest sensitivity and specificity in discriminating TSAs from TVAs were determined ; mid-zonal nucleus resulted as the best discriminating histopathologic feature (100%, 92%) followed by eosinophilia (88%, 92%),and slit-like serration (84%, 92%) with highest sensitivity and specificities, respectively. Compartmental immunohistochemical evaluation revealed that CK20 and CK7 were mainly expressed in ECF while MUC5AC together with CK7 were found in epithelial compartment more frequently in TSAs compared to TVAs. P16 was more common in TSAs in all compartments whereas Ki67 and p53 were restricted to dysplastic compartments in both polyp groups. Conclusions: The present study demonstrated that mid-zonal nuclei, eosinophilic cells and slit-like serration followed by ECF proved to be the most discriminatory features for TSAs.The correct diagnosis of TSAs will allow to develop appropriate treatment and follow up modalities which seem to be crucial as their progression rate may be different from TVAs.


Assuntos
Adenoma , Pólipos do Colo , Neoplasias Colorretais , Adenoma/diagnóstico , Neoplasias Colorretais/diagnóstico , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica
6.
Georgian Med News ; (306): 19-23, 2020 Sep.
Artigo em Russo | MEDLINE | ID: mdl-33130639

RESUMO

Nowadays CT colonoscopy is one of the basic methods for colon disease diagnostic. In Georgia mentioned method is used rarely despite of its high diagnostic potential. The current research aims to populate CT colonoscopy to be widely used in diagnostic as well as preventive healthcare, develop radiological semiotics of colon specifications and pathology changes. The research have been carried out in Batumi Referral Hospital. During the clinical researches patient's complains were gathered in details , also there was considered life , medical history and clinical research data. Following instrumental methods were used: CT colonoscopy, fibrocolonoscopy, irrigography-irrigoscopy, ultrasound research of colon. Computer Tomography researches was carried out on "General Electric" (USA) 16 layer CT scanner with 1.2 mm step by following phases: definition of research indication, preparation of intestine, insufflation, getting image, working on image and interpretation. In all cases intenstine was filled up with common air by manually method. According to 224 patients examination results in colon growing anomalies diagnostic CT colonoscopy responsivity is 98,0%, specificity 100%, diagnostic accuracy 98,2%, diverticulosis diagnostic 92,3%, 95,1%, 92,7%, and accordingly polyps in diagnostic: 87,3%, 85,6%, 85,9%. According to the gained results we can make conclusion, that CT colonoscopy is a reliable, high informational and minimally invasive diagnostic method to discover pathological disorder in colon wall and early stage cancer.


Assuntos
Pólipos do Colo , Colonografia Tomográfica Computadorizada , Colo/diagnóstico por imagem , Pólipos do Colo/diagnóstico por imagem , Colonoscopia , República da Geórgia , Humanos , Sensibilidade e Especificidade
7.
Surg Clin North Am ; 100(6): 1079-1089, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33128881

RESUMO

Advanced colonic polypectomy techniques are endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), and they aim at organ preservation with low complication rates. Main goal of endoscopic submucosal dissection (ESD) is to accomplish en-bloc resection that will subsequently allow accurate histopathological evaluation. It consists of injection, circumferential incision, and dissection of the lesion. Steps of the procedure are discussed in detail along with technological advancements.


Assuntos
Pólipos do Colo/cirurgia , Colonoscopia/métodos , Ressecção Endoscópica de Mucosa/métodos , Pólipos do Colo/patologia , Dissecação/métodos , Humanos , Mucosa Intestinal/patologia , Mucosa Intestinal/cirurgia
8.
Z Gastroenterol ; 58(10): 955-959, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33036049

RESUMO

Colonoscopy is effective in the prevention and screening of colorectal cancer. Whether terminal ileal (TI) intubation is required during conventional colonoscopy and whether it offers clinical benefits with respect to polyp detection rate (PDR) remain unclear. This retrospective study included patients who underwent colonoscopy at our hospital between July 1, 2018 and April 20, 2019. The positive findings and time for TI intubation were recorded. Univariate and multivariate analyses were performed to identify factors associated with PDR. There were 1675 patients with cecal intubation colonoscopy, including 994 (59 %) with TI intubation and 8 (1 %) with intestinal disease. The mean time for TI intubation was 40 seconds (3-338), and the mean time from cecal intubation to arrival at the deep part of TI mucosa was 24 seconds (2-118). The overall PDR was 27 %. On multivariable analysis, age > 50 years [95 % confidence interval (CI) 2.837-4.590], male sex (95 %CI, 0.406-0.649), presence of symptoms (abdominal symptoms vs. asymptomatic, 95 % CI, 1.146-2.468; stool changes vs. asymptomatic, 95 % CI, 1.070-1.834), and non-TI intubation (95 % CI, 1.040-1.648) were independent predictors of higher PDR. Trend analysis indicated decreasing trend of PDR among non-TI intubation group, 0-5 cm TI intubation group, and > 5 cm TI intubation group (30 % vs. 27 % vs. 24 %, respectively; p < 0.05). TI intubation is necessary to identify small bowel disease among a designated population, but it was not suggested to be routinely performed as part of colonoscopy, owing to limited positive intestinal findings, extra time requirement, and possible PDR worsening.


Assuntos
Pólipos do Colo/patologia , Colonoscopia/métodos , Intubação Intratraqueal , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Íleo , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
9.
Medicine (Baltimore) ; 99(41): e22402, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031275

RESUMO

BACKGROUND: Sulindac has been used for treating colorectal polyps widely. However, the efficacy and safety of sulindac for colorectal polyps are unclear. This study aims to evaluate the efficacy and safety of sulindac for colorectal polyps. METHODS: Randomized controlled trials of sulindac in the treatment of colorectal polyps will be searched in PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang, the Chongqing VIP Chinese Science, and Technology Periodical Database, and China biomedical literature database (CBM) from inception to August, 2020. And Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform, and Chinese Clinical Trials Registry will be searched to obtain more relevant studies comprehensively. Two researchers will perform data extraction and risk of bias assessment independently. Statistical analysis will be conducted in RevMan 5.3. RESULTS: This study will summarize the present evidence by exploring the efficacy and safety of sulindac in the treatment of colorectal polyps. CONCLUSION: The findings of the study will provide helpful evidence for the efficacy and safety of sulindac in the treatment of colorectal polyps, facilitating clinical practice and further scientific studies. ETHICS AND DISSEMINATION: The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/N5GDH.


Assuntos
Antineoplásicos/uso terapêutico , Pólipos do Colo/tratamento farmacológico , Sulindaco/uso terapêutico , Antineoplásicos/efeitos adversos , Humanos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Reto , Projetos de Pesquisa , Sulindaco/efeitos adversos , Revisões Sistemáticas como Assunto
10.
Medicine (Baltimore) ; 99(40): e22581, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019473

RESUMO

RATIONALE: Angiosarcoma is a highly invasive tumour with a low incidence rate but high rates of local recurrence and distant metastasis and a poor prognosis. Understanding the endoscopic characteristics of angiosarcoma will help with early diagnosis and treatment of this disease. PATIENT CONCERNS: The patient was a 77-year-old female who was admitted to the hospital due to recurring melena for 3 months. Outpatient gastroscopy showed that the patient had multiple gastric erosions. Colonoscopy revealed the presence of multiple protruding lesions in the colon and multiple rectal polyps. Pathological biopsy indicated that the patient had a tubular adenoma, which was removed by endoscopic resection. DIAGNOSES: Postsurgical pathologic assessment suggested that the histological subtype was epithelioid angiosarcoma. Positron emission tomography-computed tomography (PET-CT) revealed multiple metastases in the lymph nodes and bone. INTERVENTIONS: The patient underwent acid suppression to protect the stomach, fluid supplementation and red blood cell infusion, and subsequently, surgery, radiotherapy and chemotherapy were recommended. The patient's family refused further treatments for the patient and requested discharge. OUTCOMES: The patient refused further treatment and was not followed-up. LESSONS: Colorectal angiosarcoma is an extremely rare and highly malignant tumour, and understanding its endoscopic morphology will help aid in its diagnosis.


Assuntos
Pólipos do Colo/diagnóstico por imagem , Hemangiossarcoma/secundário , Melena/etiologia , Adenoma/cirurgia , Idoso , Biópsia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Pólipos do Colo/patologia , Colonoscopia/métodos , Feminino , Gastroscopia/métodos , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Melena/diagnóstico , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias Retais/patologia , Recusa do Paciente ao Tratamento
11.
Medicine (Baltimore) ; 99(42): e22738, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080734

RESUMO

BACKGROUND & GOALS: We observed that the number of colorectal polyps found intraoperatively was often higher than that encountered preoperatively during elective colonoscopic polypectomy. To evaluate whether more polyps can be detected when they are purposely sought than when they are routinely examined during colonoscopy. MATERIALS AND METHODS: Patients undergoing colonoscopy were randomized into groups A and B. Before colonoscopy was performed, endoscopists were instructed to seek polyps for group A purposely but not for group B. Polypectomy was electively completed. In groups A and B, the cases of elective polypectomy were named groups AR and BR, including groups AR-1 and BR-1, during the first colonoscopy and groups AR-2 and BR-2 during the second colonoscopy for polypectomy, respectively. The following data were calculated: the number of polyps detected (NPD) and the polyp detection rate (PDR) in all cases and the number of polyps missed (NPM) and partial polyp miss rate (PPMR) in the cases of colorectal polyps. RESULTS: A total of 419 cases were included in group A, 421 in group B, 43 in group AR, and 35 in group BR. No significant differences in PDR were found between groups A and B and in PPMR between groups AR-1 and BR-1 (P > .05), although PPMR in group AR-1 was higher than in group AR-2 (P < .05), similar results were found in PPMR between groups BR-1 and BR-2 (P < .05). CONCLUSION: Purposely seeking for colorectal polyps did not result in more polyps detected compared with routine colonoscopy.


Assuntos
Pólipos do Colo/diagnóstico , Colonoscopia , Pólipos do Colo/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diagnóstico Ausente/estatística & dados numéricos , Cuidados Pré-Operatórios
12.
Medicine (Baltimore) ; 99(44): e23041, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126395

RESUMO

BACKGROUND: Endoscopic mucosal resection (EMR) is a standard method commonly for removing 10 to 20 mm colorectal polyps. While the incidence of residual or recurrent after conventional EMR is remarkably high. Underwater endoscopic mucosal resection (UEMR) as an alternative technique to conventional EMR for removing colorectal polyps has high adenoma detection and complete resection rates, improves patient comfort, decreases sedation needs, eliminates the risks associated with submucosal injection, and reduces snare and diathermy-induced mucosal injury. We will conduct a comprehensive systematic review and meta-analysis to compare the effectiveness of these two therapies in the management of 10 to 20 mm colorectal polyps. METHODS: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, China Science and Technology Journal Database and Chinese Biomedical Literature Database will be searched from inception of databases to November 2020 without language limitation. Two reviewers will independently conduct article selection, data collection, and assessment of risk of bias. Any disagreement will be resolved by discussion with the third reviewer. Review Manager Software 5.3 will be used for meta-analysis. The Cochrane risk of bias tool will be used to assess the risk of bias. RESULTS: This study will provide a systematic synthesis of current published data to compare the effectiveness of UEMR and conventional EMR for 10 to 20 mm colorectal polyps. CONCLUSIONS: This systematic review and meta-analysis will provide clinical evidence as to whether UEMR is more effective and safer than conventional EMR for 10 to 20 mm colorectal polyps. STUDY REGISTRATION NUMBER: INPLASY2020100006.


Assuntos
Pólipos do Colo/cirurgia , Endoscopia , Humanos , Projetos de Pesquisa
13.
Dis Colon Rectum ; 63(11): 1496-1498, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33044289

RESUMO

CASE SUMMARY: A 31-year-old woman with a history of endometriosis was referred to the outpatient colorectal surgery office for evaluation of rectal bleeding. Colonoscopy was recommended because of the ongoing symptoms, and a polyp was discovered in the colon (). Pathology was consistent with endometriosis (). The patient was previously scheduled for laparoscopic endometriosis resection and underwent laparoscopic colon resection at the same time. She recovered and continued to do well postoperatively with no additional signs of rectal bleeding.


Assuntos
Pólipos do Colo/diagnóstico , Endometriose , Hemorragia , Laparoscopia/métodos , Protectomia/métodos , Doenças Retais , Adulto , Biópsia/métodos , Dissecação/métodos , Endometriose/complicações , Endometriose/diagnóstico , Endometriose/cirurgia , Feminino , Hemorragia/diagnóstico , Hemorragia/etiologia , Hemorragia/cirurgia , Humanos , Doenças Retais/patologia , Doenças Retais/fisiopatologia , Doenças Retais/cirurgia , Resultado do Tratamento
15.
Br J Radiol ; 93(1116): 20200670, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32941738

RESUMO

OBJECTIVES: In this study, we aimed at investigating the relationship between diverticula and in vivo colonic features such as total colon length (TCL), using CTC. We also evaluated polyps, neoplastic lesions and the correlation among them. METHODS: This retrospective study considered a series of patients who underwent CTC in our Hospital from 2010 to 2018. We evaluated TCL, the length of each colon segments and sigmoid colon diameter using dedicated software. We verified the presence of diverticula, polyps and neoplasm and measured the number of diverticula using a five-point class scale, evaluating the colonic segments involved by the disease and the number of diverticula for each segment. A logistic regression model was used to analyse the relationship between diverticula and the patients' age, sigmoid colonic diameter and the length of each colonic segments. RESULTS: The population finally included 467 patients, 177 males and 290 females (average age of 67 ± 12; range 45-96). The mean TCL was 169 ± 25 cm (range 115-241 cm). Out of the 467, 323 patients (69%) had at least one analyse. The patients with diverticula had a mean TCL significantly shorter than patients without diverticula (164 ± 22 vs 181 ± 27 cm; p = 0.001). Among the different variables, sigmoid colon length, sigmoid colon diameter and patient's age were correlated with diverticula (p < 0.01). Otherwise there is no association among diverticula, polyps and neoplasm. CONCLUSIONS: The presence of colonic diverticula was significantly inversely correlated with TCL.The TCL was not significantly correlated with polyps and cancers. ADVANCES IN KNOWLEDGE: The presence of colonic diverticula was significantly inversely correlated with total colon length, and in particular they significantly decreased with increasing colon length; our observation could contribute to the comprehension of diverticula pathogenesis.


Assuntos
Colo/anatomia & histologia , Colo/diagnóstico por imagem , Neoplasias do Colo/diagnóstico por imagem , Pólipos do Colo/diagnóstico por imagem , Colonografia Tomográfica Computadorizada , Divertículo do Colo/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
Niger J Clin Pract ; 23(8): 1048-1053, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788480

RESUMO

Aims: To describe the clinical characteristics, colonoscopic features, histological findings, dysplasia patterns, and clinical outcome of endoscopically detected colonic polyps in the Saudi population. Methods: This retrospective record review was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, on patients who underwent colonoscopy between 2005 and 2015. Patients with colorectal cancer were excluded. Data were analyzed using SPSS software. Results: Among 211 patients recruited, 66.8% were males and 66.2% were Saudi. Single polyps were detected in 45.5% of cases, while 29.9%, 18%, and 6.6% had 2, 3, and 4 polyps, respectively. Regarding the size, 81%, 17%, and 2% of the polyps were <1 cm, 1-2 cm, and >2 cm, respectively. The endoscopic examination revealed that 16.4% of the polyps were pedunculated, 82.6% were sessile, and 1% were sessile and pedunculated. About 45%, 30%, 21%, and 6.6% of the polyps were located at the rectum/sigmoid, left colon, right colon, and transverse/ascending colon, respectively. Histologically, 68.6% of polyps were adenomatous and 21.3% were non-adenomatous. Mild dysplasia was detected in almost half of the studied sample (42.3%) while moderate and severe grades of dysplasia were demonstrated in 19.2% and 38.5% of the examined polyps. Surgical intervention was required in 8.1% of cases. Conclusion: Single small-sized sessile polyps of adenomatous type and mild dysplasia are the most common polyps in the Saudi population. Sigmoid/rectum is the most common site affected, and the outcome of polyps is generally favorable.


Assuntos
Adenoma/patologia , Colo Ascendente/diagnóstico por imagem , Neoplasias do Colo/patologia , Pólipos do Colo/patologia , Colonoscopia/métodos , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Colo Ascendente/patologia , Neoplasias do Colo/epidemiologia , Pólipos do Colo/epidemiologia , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/epidemiologia , Estudos Retrospectivos , Arábia Saudita , Distribuição por Sexo
17.
West Afr J Med ; 37(4): 385-390, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32835400

RESUMO

BACKGROUND: An understanding of the natural history of colorectal polyps is relevant to the management of colorectal cancer. AIM: To study the frequency, morphology, and histopathology of colorectal polyps in a metropolis of Niger Delta region, Nigeria. PATIENTS AND METHODS: A cross-sectional retrospective study of consecutive cases of colonoscopy performed at a referral endoscopy facility in Port Harcourt metropolis, Niger Delta region of Nigeria, from March 2014 to March 2020. Variables collated included demographics, primary indication, site, morphology and histopathology of colorectal polyps. Statistical analysis was performed using IBM SPSS version 20, Armonk. NY, USA. RESULTS: A total of 496 colonoscopies were performed during the study period. The age range of patients was 4 years to 92 years (mean 54.7± 13.0). There were 357 males and 139 females. The leading primary indications for colonoscopy were gastrointestinal bleeding, routine screening for colorectal cancer and abdominal pain/discomfort in 220 (44.4%), 89 (17.9%) and 66 (13.3%) cases respectively. Colorectal polyps were recorded in 111 (22.4%) patients with a M: F of 2.7:1 and peak incidence in the 6th decade of life 53 (47.7%) cases. Majority of the polyps were seen in the colon segments extending from rectum to splenic flexure 59 (63.4%). Inflammatory, adenomatous and hyperplastic polyps were seen in 51(50.0%), 39(38.2%) and 10(9.8%) cases respectively and a sole case of malignant polyp was recorded. CONCLUSION: Adult colorectal polyps are seen predominantly in males above 50 years of age, and in the left colon. Tubular adenoma with low grade dysplasia is the most prevalent neoplastic polyp.


Assuntos
Pólipos do Colo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colonoscopia , Neoplasias Colorretais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Estudos Retrospectivos , Adulto Jovem
18.
J Cancer Res Clin Oncol ; 146(11): 2861-2870, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32772171

RESUMO

PURPOSE: IGF-1Ec is an isoform of Insulin-like growth factor 1 (IGF-1) and has recently been identified to be overexpressed in cancers including prostate and neuroendocrine tumours. The aim of this paper is to investigate the expression of IGF-1Ec in colorectal cancer and polyps compared to normal colon tissues and its association with recurrent disease using semi-quantitative immunohistochemistry. METHODS: Immunohistochemistry for IGF-1Ec expression was performed for colorectal cancer, colorectal polyps and normal colonic tissues. The quantification of IGF-1Ec expression was performed with the use of Image J software and the IHC profiler plugin. Following ethics approval from the National Research Ethics Service (Reference 11/LO/1521), clinical information including recurrent disease on follow-up was collected for patients with colorectal cancer. RESULTS: Immunohistochemistry was performed in 16 patients with colorectal cancer and 11 patients with colonic polyps and compared to normal colon tissues and prostate adenocarcinoma (positive control) tissues. Significantly increased expression of IGF-1Ec was demonstrated in colorectal cancer (p < 0.001) and colorectal polyps (p < 0.05) compared to normal colonic tissues. Colonic adenomas with high-grade dysplasia had significantly higher expression of IGF-1Ec compared to low-grade dysplastic adenomas (p < 0.001). Colorectal cancers without lymph node metastases at the time of presentation had significantly higher IGF-1Ec expression compared to lymph node-positive disease (p < 0.05). No correlation with recurrent disease was identified with IGF-1Ec expression. CONCLUSION: IGF-1Ec is significantly overexpressed in colorectal cancer and polyps compared to normal colon tissues offering a potential target to improve colonoscopic identification of colorectal polyps and cancer and intraoperative identification of colorectal tumours.


Assuntos
Pólipos Adenomatosos/diagnóstico , Pólipos do Colo/diagnóstico , Neoplasias Colorretais/diagnóstico , Fator de Crescimento Insulin-Like I/metabolismo , Pólipos Adenomatosos/metabolismo , Pólipos Adenomatosos/patologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Pólipos do Colo/metabolismo , Pólipos do Colo/patologia , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/patologia , Feminino , Humanos , Imuno-Histoquímica/métodos , Fator de Crescimento Insulin-Like I/análise , Masculino
19.
Medicine (Baltimore) ; 99(34): e21278, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846754

RESUMO

BACKGROUND: Previous studies showed difference results about the effect of nurse in improvement of the colonoscopy detection rate. This meta-analysis aims to investigate whether nurse participation during colonoscopy can help in improving the detection rate of polyps and adenomas. METHODS: Original studies in English were searched from the MEDLINE database, PubMed, Web of Science, and the Cochrane Library database. Randomized control trials (RCT) comparing colonoscopy with and without nurse participation for the detection of colorectal polyps and adenomas were identified. A meta-analysis was performed using Revman 5.3 software. RESULTS: A total of 2268 patients from 4 RCTs were included in this meta-analysis. Outcomes of colonoscopy with nurse participation were compared with those of colonoscopy without nurse participation. The results showed that nurses' participation during colonoscopy could significantly increase both, polyp detection rate and adenoma detection rate. CONCLUSION: Nurse assistance during colonoscopy can help improve the rate of detection of polyps and adenomas.


Assuntos
Pólipos do Colo/diagnóstico , Colonoscopia/enfermagem , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
Arq Bras Cir Dig ; 33(1): e1500, 2020 Jul 08.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32667530

RESUMO

BACKGROUND: One of the most important concerns on health is the increased rates of obesity in population and the speed in which this number is increasing. This number translates a serious public health problem, since it also increases the risk of several other diseases associated with obesity resulting in significant morbidity and mortality. Among them, it seems to be connected to several neoplasms, such as colorectal carcinoma. AIM: To evaluate the impact of obesity as a risk factor for colorectal carcinoma through the detection of adenoma, and to discuss the mechanisms that could establish a link between obesity and neoplasm. METHODS: Patients who underwent colonoscopy were included. Personal and anthropometric data, clinical history, and results of the tests were analyzed in order to verify the correlation of BMI and the presence of adenomatous polyps. RESULTS: A total of 142 patients were studied, which a mean age of 62 years. Of the patients, 74 (52.1%) were men and 68 (47.9%) were. Obesity was identified in 16.2% of the patients. Polyps were found in 61 (42.9%), mostly smaller than 1 cm. Obese individuals were 1.56 times more likely to present colorectal adenoma than patients with normal weight. CONCLUSION: This study, although showing the greater presence of colorectal adenomas in obese individuals, did not show a significant difference in the occurrence of pre-malignant lesions.


Assuntos
Adenoma/epidemiologia , Neoplasias Colorretais/epidemiologia , Pólipos Adenomatosos , Pólipos do Colo , Colonoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade , Fatores de Risco
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