ABSTRACT
Systematic investigations testing for the presence of polyps and cancers of the large bowel were conducted in a population of 1,369 inpatients and outpatients, aged 45-70 years, in eight university departments of gastroenterology or abdominal surgery (Toulouse, Dijon, Paris, Marseille, and Strasbourg). Double-contrast barium enema and proctosigmoidoscopy examinations were carried out in all cases, whereas total coloscopy was performed only in the case of detected tumors. A questionnaire including 233 parameters (age, sex, family, and personal history and symptoms) was completed for each patient. A total of 414 lesions were detected in 252 patients, including 245 adenomatous or villous polyps, 8 transformed polyps, and 30 carcinomas; 3 of 4 lesions were located in the rectum or sigmoid. Cancer or adenomatous or villous polyps were found in 13% of the patients. The prevalence of these lesions in the population studied was increased in patients with rectorrhagia (19%) or with a personal history of surgery for colorectal cancer or polyp (23%). In the patients without rectorrhagia or a history of intestinal tumor, the incidence was 9.7%. It was significantly increased in males and patients more than 50 year old. The efficacy of proctosigmoidoscopy and double-contrast barium enema was compared in 909 patients. Sensitivity and specificity were, respectively, 35% and 99% for endoscopy, 96% and 94% for radiology.
Subject(s)
Colonic Neoplasms/diagnosis , Intestinal Polyps/diagnosis , Rectal Neoplasms/diagnosis , Aged , Barium Sulfate , Colonic Neoplasms/pathology , Endoscopy , Female , France , Humans , Intestinal Polyps/epidemiology , Intestinal Polyps/pathology , Male , Middle Aged , Rectal Neoplasms/pathology , RiskSubject(s)
Colitis, Ulcerative/surgery , Gastrointestinal Hemorrhage/surgery , Postoperative Complications , Rectum/pathology , Adolescent , Adult , Aged , Female , Follow-Up Studies , Humans , Ileum/surgery , Intestinal Mucosa/pathology , Male , Middle Aged , Postoperative Complications/prevention & control , Rectal Neoplasms/etiology , Rectum/surgeryABSTRACT
The rubber ligation, ambulatory treatment of hemorroids due to J. Barron, consists in the strangulation of hemorroidal packs by an elastric ring, assuring the destruction by ischemic necrosis. Widely spread in France since 1968, the treatment forms the subject of a retrospective enquiry among 30 french proctologists, after ten years of experiment. It bears on 1074 patients and 4122 ligatures. The prolapsus disappeared in 60% of the cases and disminished in 32%. The hemorragies have stopped in 69% and these results go on beyond four years in 87% of the cases. Less heterogenous statistics and more precise indications would improve these results which, however, confirm the efficience of the treatment.
Subject(s)
Ambulatory Care , Hemorrhoids/therapy , Adult , Aged , Gastrointestinal Hemorrhage/therapy , Humans , Ligation/methods , Methods , Middle Aged , Prolapse , Retrospective Studies , RubberABSTRACT
A total of 37 ambulatory patients with proctological conditions were treated with Ginkor as preparatory therapy before instrumental treatment (sclerosants or elastic ligatures). Greater importance was attached to its hemostatic activity; always objective though sometimes transitory, than to the improvement in various painful functional syndromes. Changes in hemorrhoidal morphology were not included in the assessment, as they demonstrate very little in the course of general treatment, except in bouts of acute inflammation and more particularly when oedema and thrombis occur. After treatment, the functional syndrome (heaviness, tenesmus) which was present in 29 patients was absent in 9 cases, reduced in 13, and unchanged in 7. Pruritus ani, which was present in 14 patients, was absent in 4 cases, reduced in 5, unchanged in 4, and impossible to evaluate in 1 case. Rectorrhagia disappeared in 12 out of 20 cases, was reduced in 4 cases, and persisted in 4 others. Overall, there were 12 very satisfactory results, 13 incomplete results, 3 moderate results, and 9 cases where no effect was noted.
Subject(s)
Flavonoids/therapeutic use , Hemorrhoids/drug therapy , Hemostatics/therapeutic use , Rectal Diseases/drug therapy , Adult , Aged , Ambulatory Care , Female , Hemorrhoids/complications , Humans , Male , Middle Aged , Rectal Diseases/complicationsSubject(s)
Adenoma/pathology , Adolescent , Aged , Child , Colon/pathology , Humans , Intestinal Neoplasms/pathology , Intestinal Polyps/classification , Intestinal Polyps/etiology , Intestinal Polyps/genetics , Intestinal Polyps/pathology , Neoplasm Recurrence, Local , Peutz-Jeghers Syndrome/pathology , Rectum/pathology , Schistosomiasis/complicationsSubject(s)
Intestinal Polyps , Adult , Aged , Child , Cysts/complications , Diarrhea/etiology , Female , Gastrointestinal Hemorrhage/etiology , Humans , Infant , Intestinal Polyps/genetics , Intestinal Polyps/pathology , MaleSubject(s)
Colonic Neoplasms/diagnosis , Intestinal Polyps/diagnosis , Adolescent , Child , Child, Preschool , Colitis/diagnosis , Diagnosis, Differential , Endoscopy , Female , Humans , Intestinal Polyps/genetics , MaleSubject(s)
Anus Diseases , Homosexuality , Lymphogranuloma Venereum , Papilloma , Sex Factors , Sexually Transmitted Diseases , SyphilisSubject(s)
Gonorrhea , Rectal Diseases/microbiology , Adult , Age Factors , Bacteriological Techniques , Female , Gonorrhea/diagnosis , Humans , Male , Rectal Diseases/diagnosisABSTRACT
Four hundred and thirty-three patients with adenomatous polyps were examined and followed up. It was found that well differentiated adenomas are stable but dedifferentiated polyps can lead to invasive cancer, usually over a long period of time. Thus the concept of malignant transformation becomes meaningless, and should be replaced by an initial histological evaluation of polyps of the rectum and colon so that their development can be predicted.
