Gastroenteroloji ünitemizdeki kolonoskopi sonuçlarımızla birlikte, endikasyonlar komplikasyonlar ve işlem başarısının değerlendirilmesi
Öz
Giriş ve Amaç:Günümüzde kolorektal patolojilerin araştırılmasında en iyi tanısal yöntem kolonoskopi olarak adlandırılan endoskopik incelemedir. Bu çalışmadaki amacımız, Selçuk Üniversitesi Tıp Fakültesi Gastroenteroloji Bilim Dalı’nda alt gastrointestinal sistem endoskopisi (kolonoskopi) uygulanan hastalarda, işlem endikasyonları, başarı oranı ve komplikasyonları ile birlikte, kolonoskopi sonuçlarının retrospektif olarak değerlendirilmesidir. Gereç ve Yöntem: Gastroenteroloji Endoskopi Ünitesi’nde Ocak 2012 ile Temmuz 2014 arasında çeşitli endikasyonlarla kolonoskopi yapılmış hastaların kolonoskopi raporları endoskopi arşiv sisteminden retrospektif olarak tarandı. Bulgular:Toplam 1500 hastaya kolonoskopi yapılmış olup vakaların 764 (%50.9) ü erkek ve 736 (%49.1) sı kadındı. Yapılan kolonoskopilerin sonucunda %48.4 hastada herhangi bir patoloji saptanmazken, en sık olarak hemoroid (%15) ve bunu takiben de ikinci sıklıkta polip (%13.3) tespit edildi. Kolonoskopi endikasyonları içinde konstipasyon en sık neden olarak tespit edildi. %21.9 hastada kolon temizliğinin yetersiz olduğu gözlendi. Sonuç: Bu çalışmamızın sonucunda kolonoskopi endikasyonlarının geniş tutuldu-ğu, ayrıca kolon temizliğinin yaklaşık beş hastanın birinde yetersiz olduğu, bunun da ikinci bir iş yükü ve maliyet getirdiği tespit edilmiştir.
Anahtar Kelimeler
Alt gastrointestinal sistem kolonoskopi tanı komplikasyonlar
Kaynakça
- 1. Minali G, Meucci G, Bartoli A, et al. The ASGE guidelines for the appropriate use of colonoscopy in an open access system. Gastrointest Endosc 2000;52:39-44.
- 2. Winawer S, Fletcher R, Rex D, et al. Gastrointestinal Consortium Panel: Colorectal cancer screening and surveillance: clinical guidelines and rationale-update based on new evidence, Gastroenterology 2003;124:544-60.
- 3. Smith RA, Cokkinides V, Brawley OW. Cancer screening in the United States, 2009: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin 2009;59:27-41.
- 4. Lieberman DA, Weiss DG, Bond JH, et al. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. N Engl J Med 2000;343:162-8.
- 5. Vennes JA. Gastrointestinal Endoscopy. In: Wyngaarden JB, Lloyd SH Jr, Bennett JC. (Editors). Cecil Textbook of Medicine, 19th Edition. Philadelphia: W. B. Saunders Company 1992; 630-4.
- 6. Smith RA, Cokkinides V, Eyre HJ; American Cancer. Society. American Cancer Society guidelines for the early detection of cancer, 2003. CA Cancer J Clin 2003;53:27-43.
- 7. Rex DK, Bond JH, Winawer S, et al; Multi Society Task Force on Colorectal Cancer. Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi Society Task Force on Colorectal Cancer. Am J Gastroenterol 2002;97:1296-308.
- 8. Rex DK, Petrini JL, Baron TH, et al. Quality indicators in colonoscopy. Gastrointest Endosc 2006;63(4 Suppl):S16-28.
- 9. Balık AA, Çelebi F, Atamanalp SS, et al. Alt gastrointestinal sistem endoskopi sonuçlarımız. Atatürk Üniversitesi Tıp Dergisi 2000;32:101-4.
- 10. Şit M, Aktaş G, Yılmaz EE. Alt gastrointestinal endoskopi sonuçlarımız: Ağrı Doğubayazıt Bölgesi. Kocaeli Tıp Dergisi 2012;3:1-4
- 11. Izbul T, Akalın M. The evaluation of diagnostic rectosigmoidoscopic examinations in Turkish Republic of Northern Cyprus. Turk J Gastroenterol 1999;10:268-71.
- 12. Yaşar M, Kayıkçı A. Kolonoskopi sonuçlarımızın retrospektif analizi. Konuralp Tıp Dergisi 2010;2:6-9.
- 13. Boland CR, Hzkowitz SH, Kim YS (Editors). Colonic polyps and gastrointestinal polipozis syndromes. Gastrointestinal disease, Sleisenger MH, Fordran JSS, Philedelphia ,WB Saunders Company 1989;2:1483-1518.
- 14. Winawer SJ, Zauber AG, Fletcher RH, et al; US Multi-Society Task Force on Colorectal Cancer; American Cancer Society. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology 2006;130:1872-85.
- 15. Bahçecioğlu İH, Güzel Z, Çelebi H, et al. 1990-1995 yılları arasında kliniğimizde yapılan rektoskopi ve kolonoskopi sonuçlarının değerlendirilmesi. Gastroenteroloji 1996;7 (Supp 1):107.
- 16. Dolar ME, Gültekin M, Nak SG, et al. Kolonoskopik incelemenin değerlendirilmesi. 9. Ulusal Türk Gastroenteroloji Kongresi. 1994, P: 410.
- 17. Heitman SJ, Ronksley PE, Hilsden RJ, et al. Prevalence of adenomas and colorectal cancer in average risk individuals: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2009;7:1272-8.
- 18. Sànchez A, Munoz C, Bujanda L, et al. The value of colonoscopy to assess rectal bleeding in patients referred from Primary Care Units. Rev Esp Enferm Dig 2005;97:870-6.
- 19. Tamer A, Korkut E, Korkmaz U ve ark. Alt gastrointestinal endoskopi sonuçlarımız: Düzce Bölgesi. The Medical Journal of Kocatepe 2005;6:29-31.
- 20. Siddique I, Mohan K, Hasan F, et al. Appropriateness of indication and diagnostic yield of colonoscopy: First report based on the 2000 guidelines of the American Society for Gastrointestinal Endoscopy. World J Gastroenterol 2005;11:7007-13.
- 21. Russel MG. Changes in the incidance of inflammatory bowel disease: what does it mean? Eur J Intern Med 2000;11:191-6.
- 22. Viiala CH, Zimmerman M, Cullen DJ, Hoffman NE. Complication rates of colonoscopy in an Australian teaching hospital environment. Intern Med J. 2003;33:355-9.
- 23. Garbay JR, Suc B, Rotman N, et al. Multicentre study of surgical complications of colonoscopy. Br J Surg 1996;83:42-4.
Evaluation of colonoscopy outcomes with the indications, complications, and success of the procedure in our gastroenterology unit
Öz
Background and Aims:Currently, colonoscopy is the gold standard to determine colorectal pathologies. Colonoscopy provides an excellent view of the mucosal surface from the anal canal to the terminal ileum. The aim of this study was to retrospectively evaluate colonoscopy results, indications, complications and the success of the procedure between January 2012 and July 2014 at the Gastrointestinal Endoscopy Unit at Selcuk University. Materials and Methods:Retrospective analysis of medical charts and pathological results of patients who underwent lower gastrointestinal system endoscopies during the period 2012-2014 was performed. Results:A total of 1500 patients underwent colonoscopic examinations; 764 (50.9%) of the patients were male, 736 (49.1%) were female. Colonoscopic findings were as follows: 48.4% of the patients had no pathology, 15% had hemorrhoids, 13.3% had polyps and 1.4% colorectal cancers. Colon cleansing was inadequate in 21.9% of patients presenting for colonoscopy. Conclusion: Approximately half of the patients had normal colonoscopic findings that suggests that the indications for colonoscopy were expanded. One in five patients had inadequate colon cleansing which caused extra effort and cost.
Anahtar Kelimeler
Lower gastrointestinal system colonoscopy indications diagnosis
Kaynakça
- 1. Minali G, Meucci G, Bartoli A, et al. The ASGE guidelines for the appropriate use of colonoscopy in an open access system. Gastrointest Endosc 2000;52:39-44.
- 2. Winawer S, Fletcher R, Rex D, et al. Gastrointestinal Consortium Panel: Colorectal cancer screening and surveillance: clinical guidelines and rationale-update based on new evidence, Gastroenterology 2003;124:544-60.
- 3. Smith RA, Cokkinides V, Brawley OW. Cancer screening in the United States, 2009: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin 2009;59:27-41.
- 4. Lieberman DA, Weiss DG, Bond JH, et al. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. N Engl J Med 2000;343:162-8.
- 5. Vennes JA. Gastrointestinal Endoscopy. In: Wyngaarden JB, Lloyd SH Jr, Bennett JC. (Editors). Cecil Textbook of Medicine, 19th Edition. Philadelphia: W. B. Saunders Company 1992; 630-4.
- 6. Smith RA, Cokkinides V, Eyre HJ; American Cancer. Society. American Cancer Society guidelines for the early detection of cancer, 2003. CA Cancer J Clin 2003;53:27-43.
- 7. Rex DK, Bond JH, Winawer S, et al; Multi Society Task Force on Colorectal Cancer. Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi Society Task Force on Colorectal Cancer. Am J Gastroenterol 2002;97:1296-308.
- 8. Rex DK, Petrini JL, Baron TH, et al. Quality indicators in colonoscopy. Gastrointest Endosc 2006;63(4 Suppl):S16-28.
- 9. Balık AA, Çelebi F, Atamanalp SS, et al. Alt gastrointestinal sistem endoskopi sonuçlarımız. Atatürk Üniversitesi Tıp Dergisi 2000;32:101-4.
- 10. Şit M, Aktaş G, Yılmaz EE. Alt gastrointestinal endoskopi sonuçlarımız: Ağrı Doğubayazıt Bölgesi. Kocaeli Tıp Dergisi 2012;3:1-4
- 11. Izbul T, Akalın M. The evaluation of diagnostic rectosigmoidoscopic examinations in Turkish Republic of Northern Cyprus. Turk J Gastroenterol 1999;10:268-71.
- 12. Yaşar M, Kayıkçı A. Kolonoskopi sonuçlarımızın retrospektif analizi. Konuralp Tıp Dergisi 2010;2:6-9.
- 13. Boland CR, Hzkowitz SH, Kim YS (Editors). Colonic polyps and gastrointestinal polipozis syndromes. Gastrointestinal disease, Sleisenger MH, Fordran JSS, Philedelphia ,WB Saunders Company 1989;2:1483-1518.
- 14. Winawer SJ, Zauber AG, Fletcher RH, et al; US Multi-Society Task Force on Colorectal Cancer; American Cancer Society. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology 2006;130:1872-85.
- 15. Bahçecioğlu İH, Güzel Z, Çelebi H, et al. 1990-1995 yılları arasında kliniğimizde yapılan rektoskopi ve kolonoskopi sonuçlarının değerlendirilmesi. Gastroenteroloji 1996;7 (Supp 1):107.
- 16. Dolar ME, Gültekin M, Nak SG, et al. Kolonoskopik incelemenin değerlendirilmesi. 9. Ulusal Türk Gastroenteroloji Kongresi. 1994, P: 410.
- 17. Heitman SJ, Ronksley PE, Hilsden RJ, et al. Prevalence of adenomas and colorectal cancer in average risk individuals: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2009;7:1272-8.
- 18. Sànchez A, Munoz C, Bujanda L, et al. The value of colonoscopy to assess rectal bleeding in patients referred from Primary Care Units. Rev Esp Enferm Dig 2005;97:870-6.
- 19. Tamer A, Korkut E, Korkmaz U ve ark. Alt gastrointestinal endoskopi sonuçlarımız: Düzce Bölgesi. The Medical Journal of Kocatepe 2005;6:29-31.
- 20. Siddique I, Mohan K, Hasan F, et al. Appropriateness of indication and diagnostic yield of colonoscopy: First report based on the 2000 guidelines of the American Society for Gastrointestinal Endoscopy. World J Gastroenterol 2005;11:7007-13.
- 21. Russel MG. Changes in the incidance of inflammatory bowel disease: what does it mean? Eur J Intern Med 2000;11:191-6.
- 22. Viiala CH, Zimmerman M, Cullen DJ, Hoffman NE. Complication rates of colonoscopy in an Australian teaching hospital environment. Intern Med J. 2003;33:355-9.
- 23. Garbay JR, Suc B, Rotman N, et al. Multicentre study of surgical complications of colonoscopy. Br J Surg 1996;83:42-4.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 29 Nisan 2015 |
| Yayımlandığı Sayı | Yıl 2015 |