RESUMO: OBJETIVOS: O estudo visa comparar o preparo intestinal para colonoscopia com manitol a 10%, com o uso de polietilenoglicol (PEG). Trabalho realizado no Serviço de Coloproctologia do Hospital São Lucas da PUCRS -RS -Brasil. Recebido em 05/12/2008Aceito para publicação em 14/01/2009 INTRODUÇÃOA endoscopia do intestino grosso tornou-se, nas últimas décadas, procedimento padrão para a investigação de várias afecções do cólon, inclusive o rastreamento do câncer do intestino, assim como de suas formas pré-malignas 1 . Ainda, é exame capaz, através da remoção de lesões pré-malignas, de reduzir a mortalidade por câncer colo-retal 2,3,4 . Para o exame ter seu rendimento ótimo, é necessária a limpeza dos resíduos fecais naturalmente presentes no órgão, e vários procedimentos para tal têm sido testados durante a evolução do procedimento. Atualmente, os méto-dos mais utilizados na prática médica têm sido as lavagens ortógradas com soluções de polietilenoglicol (PEG), manitol ou Fosfato de Sódio 5 . São escassos os estudos comparativos entre os três métodos na literatura, e em sua maioria não levam em conta alterações bioquímicas causadas pela ingestão das soluções, nem o custo relacionado a cada tipo de preparo 6,7 . Ainda há nos Estados Unidos um consenso atual em não utilizar manitol para preparo intestinal, tendo preferência as soluções de PEG 8 , e estudos de metanálise incluem poucos trabalhos com o
Background Colorectal cancer (CRC) is the third most common cancer among men, and the second among women worldwide. In Brazil, the incidence and mortality of CRC continues to increase. In colonoscopies, adenoma detection rates (ADRs) higher than 25% are associated linearly with better outcomes and lower rates of interval cancer. Objective To assess the colonoscopy quality indexes. Methods This is a cross-sectional retrospective study in which anatomopathological data and data regarding the colonoscopies were collected from the patient records of Hospital Moinhos de Vento, in Southern Brazil. The exams were performed by doctors from the Colorectal Service from June to August 2015. Results A total of 430 exams were included. Most patients were women (60.9% [262]), with a mean age of 56.96 years. The cecal intubation rate was of 96.7% (416). The quality of the bowel preparation was excellent or good in 92.95% (396) of the cases. The average time of removal of the colonoscope in normal exams was of 6.15 minutes. Polyps were detected in 201 patients (46.7%), and adenomas, in 125 patients (29.1%); 12 patients (2.8%) had advanced adenomas, and 6 (2.3%) had malignant neoplasms. The proximal serrated lesion detection rate (PSLDR) was of 6.7% (29). The prevalence ratio (PR) of adenomas among men was 1.78 times greater than in women (95% confidence interval [95%CI]: 1.16–2.75). The PR of adenomas among people aged 50 years or older was 2.41 times that of those under 50 years of age (95%CI: 1.43–4.06). Conclusion The data obtained are in line with international quality criteria in colonoscopy. More studies are needed to assess the ADR in the Brazilian population.
Background: Radiotherapy is widely used in the treatment of several pelvic neoplasms, Radiation-related adverse events may result in intestinal, urinary, sexual, bone and dermatological disorders, impacting quality of life. The prevalence of radiation proctitis is probably underestimated. The aim of this study is to assess the quality of life associated with radiation proctitis in patients undergoing pelvic radiotherapy.Methods: A cohort of 40 consecutive patients from an academic institution in Brazil who received pelvic radiotherapy was analyzed. Patients completed questionnaires EORTC QLQ-C30 and EORTC QLQ-PRT20 at the beginning and at the end of treatment. Clinico-pathological features were also collected using standard templates. Results: Thirty-seven patients were included in the analysis. Thirty-two patients (80%) were male and had prostate cancer. Pelvic radiotherapy was associated with worsening bowel control (p=0.0171) leakage (p=0.0542) and pain (p=0.0074) in EORTC QLQ-PRT20. Patients had increased number of bowel movements per day after treatment (p=0.0036). Fatigue (p=0.0176) and diarrhea (p=0.0103) increased after radiation therapy. There was no statistical difference in global quality of life in patients who received radiotherapy. Conclusion: EORTC QLQ-PRT20 questionnaire is suitable for assessing the quality of life related to radiation proctitis in patients undergoing pelvic radiotherapy. This tool may help clinicians in the management and monitoring of treatment-related adverse events of this treatment modality.
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