RESUMO
OBJECTIVE: To compare air insufflation with water irrigation during routine diagnostic flexible cystoscopy. PATIENTS AND METHODS: A total of 200 consecutive patients scheduled for routine diagnostic flexible cystoscopy under topical anaesthesia were randomized prospectively to either air insufflation or water irrigation. Their tolerance to the procedure and post-operative symptoms were assessed from a questionnaire completed immediately after the procedure and then 1 week later. RESULTS: Air insufflation offered a better cystoscopic view than water irrigation. With regard to tolerance, in the air insufflation group, 72% reported the procedure to be comfortable, 22% uncomfortable and 6% painful compared to 44%, 45% and 11% respectively in the water irrigation group. This difference in favour of air insufflation was highly significant (Chi-square, P < 0.001). There was no statistical difference in either post-operative symptoms a week later or in the diagnostic yield between the two study groups. There were no complications in either group. CONCLUSION: Air insufflation cystoscopy is as safe and effective as water irrigation but better tolerated by patients. This, together with its more obvious advantages of the ease of administration and low cost, should prompt more routine use of air insufflation cystoscopy for day case procedures.
Assuntos
Cistoscopia/métodos , Insuflação , Irrigação Terapêutica , Carcinoma de Células de Transição/diagnóstico , Hematúria/etiologia , Humanos , Satisfação do Paciente , Estudos Prospectivos , Neoplasias da Bexiga Urinária/diagnósticoRESUMO
Emergency left-sided colonic resections have traditionally been dealt with by employing staged resections due to the dangers of an anastomosis in unprepared bowel. A small series of 6 patients with left-sided colonic obstruction is presented in which a single stage primary anastomosis was done after an antegrade intraoperative colonic lavage. There were no deaths, infective complications or anastomotic leaks. Major series in the last decade using intraoperative colonic lavage are reviewed as well, to confirm that the method is safe, effective and warrants wider usage locally.
