Flexible Sigmoidoscopy
No Results
No Results
processing….
Flexible sigmoidoscopy is a procedure wherein a sigmoidoscope is inserted through the anus, the distal colonic mucosa (up to 60 cm from the anal verge) is examined, and any diagnostic or therapeutic maneuvers performed, as needed.
Intracolonic visualization with an endoscope dates back to 1958, when Matsunaga used a gastroscope for this purpose in Japan. [1] The next step was the incorporation of the fiberoptic bundles into the gastroscopes, which in turn led to the development of the first fiberoptic flexible sigmoidoscope by Overholt and its successful use in 1963. [1] Continuing development through the years has led to the modern sigmoidoscope, which uses a charge–coupled device connected to a video processor.
Alternatives to flexible sigmoidoscopy include the following:
The following are the usual indications for flexible sigmoidoscopy [5] :
Absolute contraindications for flexible sigmoidoscopy include the following:
Relative contraindications for flexible sigmoidoscopy include the following:
The rectum lies in the sacrococcygeal hollow and changes to the anal canal at the puborectal sling formed by the innermost fibers of the levator ani. The rectum has a dilated middle part called the ampulla. The rectum is related anteriorly to the urinary bladder, prostate, seminal vesicles, and urethra in males and to the uterus, cervix, and vagina in females. Anterior to the rectum is the rectovesical pouch in males and the rectouterine pouch in females. The anal canal is related to the perineal body in front and the anococcygeal body behind; both of these are fibromuscular structures.
For more information about the relevant anatomy, see Large Intestine Anatomy, Colon Anatomy, and Anal Canal Anatomy.
The following measures are recommended for improving the performance of flexible sigmoidoscopy:
Haycock A, Cohen C, Saunders B, Cotton PB, Williams CB. Cotton and Williams’ Practical Gastrointestinal Endoscopy: The Fundamentals. 7th ed. Chichester, UK: John Wiley & Sons; 2014.
Stern C. Flexible sigmoidoscopy versus fecal occult blood testing for colorectal cancer screening in asymptomatic individuals. Clin J Oncol Nurs. 2014 Aug. 18 (4):471-2. [Medline].
Regge D, Iussich G, Senore C, Correale L, Hassan C, Bert A, et al. Population screening for colorectal cancer by flexible sigmoidoscopy or CT colonography: study protocol for a multicenter randomized trial. Trials. 2014 Mar 28. 15:97. [Medline]. [Full Text].
Duarte RB, Bernardo WM, Sakai CM, Silva GL, Guedes HG, Kuga R, et al. Computed tomography colonography versus colonoscopy for the diagnosis of colorectal cancer: a systematic review and meta-analysis. Ther Clin Risk Manag. 2018. 14:349-360. [Medline]. [Full Text].
Cappell MS, Friedel D. The role of sigmoidoscopy and colonoscopy in the diagnosis and management of lower gastrointestinal disorders: technique, indications, and contraindications. Med Clin North Am. 2002 Nov. 86 (6):1217-52. [Medline].
[Guideline] Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2017 Jul. 112 (7):1016-1030. [Medline].
Preventive services for adults: level I – colorectal cancer screening. Institute for Clinical Systems Improvement (ICSI). Available at https://www.icsi.org/guideline_sub-pages/preventive_services_adults/level_i__colorectal_cancer_screening/. 2018; Accessed: March 27, 2018.
Armaroli P, Villain P, Suonio E, Almonte M, Anttila A, Atkin WS, et al. European Code against Cancer, 4th Edition: Cancer screening. Cancer Epidemiol. 2015 Dec. 39 Suppl 1:S139-52. [Medline].
Doroudi M, Schoen RE, Pinsky PF. Early detection versus primary prevention in the PLCO flexible sigmoidoscopy screening trial: Which has the greatest impact on mortality?. Cancer. 2017 Dec 15. 123 (24):4815-4822. [Medline].
Holme Ø, Schoen RE, Senore C, Segnan N, Hoff G, Løberg M, et al. Effectiveness of flexible sigmoidoscopy screening in men and women and different age groups: pooled analysis of randomised trials. BMJ. 2017 Jan 13. 356:i6673. [Medline]. [Full Text].
Holme Ø, Bretthauer M, Fretheim A, Odgaard-Jensen J, Hoff G. Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals. Cochrane Database Syst Rev. 2013 Oct 1. 9:CD009259. [Medline].
Ormarsson OT, Asgrimsdottir GM, Loftsson T, Stefansson E, Kristinsson JO, Lund SH, et al. Clinical trial: free fatty acid suppositories compared with enema as bowel preparation for flexible sigmoidoscopy. Frontline Gastroenterol. 2015 Oct. 6 (4):278-283. [Medline].
Cappell MS, Friedel D. The role of sigmoidoscopy and colonoscopy in the diagnosis and management of lower gastrointestinal disorders: endoscopic findings, therapy, and complications. Med Clin North Am. 2002 Nov. 86 (6):1253-88. [Medline].
Levin TR, Farraye FA, Schoen RE, Hoff G, Atkin W, Bond JH, et al. Quality in the technical performance of screening flexible sigmoidoscopy: recommendations of an international multi-society task group. Gut. 2005 Jun. 54 (6):807-13. [Medline].
Gaurav Arora, MD, MS Assistant Professor of Internal Medicine, Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School
Gaurav Arora, MD, MS is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, American Association of Physicians of Indian Origin
Disclosure: Nothing to disclose.
Frank J Lukens, MD Assistant Professor of Medicine, Program Director of GI Fellowship Program, Director of Endoscopy and Endoscopic Training, Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center at Houston Medical School
Frank J Lukens, MD is a member of the following medical societies: American Society for Gastrointestinal Endoscopy, Texas Medical Association
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Vikram Kate, MBBS, MS, PhD, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS Professor of General and Gastrointestinal Surgery and Senior Consultant Surgeon, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), India
Vikram Kate, MBBS, MS, PhD, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS is a member of the following medical societies: American College of Gastroenterology, American College of Surgeons, American Society of Colon and Rectal Surgeons, Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of England
Disclosure: Nothing to disclose.
Joseph K Lim, MD Associate Professor of Medicine, Director, Yale Viral Hepatitis Program, Section of Digestive Diseases, Yale University School of Medicine
Joseph K Lim, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.
Medscape Reference thanks Dawn Sears, MD, Associate Professor of Internal Medicine, Division of Gastroenterology and Hepatology, Scott and White Memorial Hospital; and Dan C Cohen, MD, Fellow in Gastroenterology, Scott and White Hospital, Texas A&M Health Science Center College of Medicine, for assistance with the video contribution to this article.
Flexible Sigmoidoscopy
Research & References of Flexible Sigmoidoscopy|A&C Accounting And Tax Services
Source
0 Comments