RESUMO
BACKGROUND: Rectal bleeding is a sign of colorectal cancer (CRC). Its early diagnosis decreases mortality and improves survival. In young population with no risk factors for the disease, CRC is infrequent. Moreover, benign anorectal disorders are most frequent causes of bleeding and generally, when anal pathology is identified, it is assumed as the origin of the sign. For all these reasons, rectal bleeding sometimes is sub-assessed in young patients. OBJECTIVE: Estimate the prevalence of adenomas and adenocarcinomas in sigmoid and rectum in patients younger than 50 years old referred for proctorrhagia. METHODS: The study design was descriptive, retrospective and cross-sectional. Procedures were performed under sedation and Olympus CF 160 y CF 180 scopes were used. Proctorrhagia was considered as rectal bleeding registered as indication of the procedure. Histology was established according to Vienna classification. Informed consent was signed before the procedures. Colonoscopy reports were reviewed. The study took place in an outpatient clinic in Buenos Aires city, between October 2010 and October 2011. High risk patients for CRC were excluded RESULTS: We included 1,203 from 1,257 reviewed VCC, 49% were female and the median age was 38 years old (range: 18-49 years old). The prevalence of adenomas and adenocarcinomas in sigmoid and rectum was 67% [95% confidence interval (95% CI): 5.4-8.3] and 1.6% (95% CI 1-2.5), respectively. CONCLUSIONS: Adenocarcinomas and adenomas are infrequent in a young population without risk factors for CRC. However, even when benign anal disorders are the most frequent cause for rectal bleeding, miss evaluation of this sign could have a serious impact in almost 10 of 100 individuals.
Assuntos
Adenocarcinoma/epidemiologia , Hemorragia Gastrointestinal/etiologia , Neoplasias Retais/epidemiologia , Neoplasias do Colo Sigmoide/epidemiologia , Adenocarcinoma/complicações , Adolescente , Adulto , Colonoscopia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Neoplasias Retais/complicações , Estudos Retrospectivos , Neoplasias do Colo Sigmoide/complicações , Adulto JovemRESUMO
BACKGROUND: Rectal bleeding is a sign of colorectal cancer (CRC). Its early diagnosis decreases mortality and improves survival. In young population with no risk factors for the disease, CRC is infrequent. Moreover, benign anorectal disorders are most frequent causes of bleeding and generally, when anal pathology is identified, it is assumed as the origin of the sign. For all these reasons, rectal bleeding sometimes is sub-assessed in young patients. OBJECTIVE: Estimate the prevalence of adenomas and adenocarcinomas in sigmoid and rectum in patients younger than 50 years old referred for proctorrhagia. METHODS: The study design was descriptive, retrospective and cross-sectional. Procedures were performed under sedation and Olympus CF 160 y CF 180 scopes were used. Proctorrhagia was considered as rectal bleeding registered as indication of the procedure. Histology was established according to Vienna classification. Informed consent was signed before the procedures. Colonoscopy reports were reviewed. The study took place in an outpatient clinic in Buenos Aires city, between October 2010 and October 2011. High risk patients for CRC were excluded RESULTS: We included 1,203 from 1,257 reviewed VCC, 49
were female and the median age was 38 years old (range: 18-49 years old). The prevalence of adenomas and adenocarcinomas in sigmoid and rectum was 67
[95
confidence interval (95
CI): 5.4-8.3] and 1.6
(95
CI 1-2.5), respectively. CONCLUSIONS: Adenocarcinomas and adenomas are infrequent in a young population without risk factors for CRC. However, even when benign anal disorders are the most frequent cause for rectal bleeding, miss evaluation of this sign could have a serious impact in almost 10 of 100 individuals.
Assuntos
Adenocarcinoma/epidemiologia , Hemorragia Gastrointestinal/etiologia , Neoplasias Retais/epidemiologia , Neoplasias do Colo Sigmoide/epidemiologia , Adenocarcinoma/complicações , Adolescente , Adulto , Colonoscopia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Neoplasias Retais/complicações , Estudos Retrospectivos , Neoplasias do Colo Sigmoide/complicações , Adulto JovemRESUMO
BACKGROUND: Rectal bleeding is a sign of colorectal cancer (CRC). Its early diagnosis decreases mortality and improves survival. In young population with no risk factors for the disease, CRC is infrequent. Moreover, benign anorectal disorders are most frequent causes of bleeding and generally, when anal pathology is identified, it is assumed as the origin of the sign. For all these reasons, rectal bleeding sometimes is sub-assessed in young patients. OBJECTIVE: Estimate the prevalence of adenomas and adenocarcinomas in sigmoid and rectum in patients younger than 50 years old referred for proctorrhagia. METHODS: The study design was descriptive, retrospective and cross-sectional. Procedures were performed under sedation and Olympus CF 160 y CF 180 scopes were used. Proctorrhagia was considered as rectal bleeding registered as indication of the procedure. Histology was established according to Vienna classification. Informed consent was signed before the procedures. Colonoscopy reports were reviewed. The study took place in an outpatient clinic in Buenos Aires city, between October 2010 and October 2011. High risk patients for CRC were excluded RESULTS: We included 1,203 from 1,257 reviewed VCC, 49
were female and the median age was 38 years old (range: 18-49 years old). The prevalence of adenomas and adenocarcinomas in sigmoid and rectum was 67
CI): 5.4-8.3] and 1.6
CI 1-2.5), respectively. CONCLUSIONS: Adenocarcinomas and adenomas are infrequent in a young population without risk factors for CRC. However, even when benign anal disorders are the most frequent cause for rectal bleeding, miss evaluation of this sign could have a serious impact in almost 10 of 100 individuals.
Assuntos
Adenocarcinoma/epidemiologia , Hemorragia Gastrointestinal/etiologia , Neoplasias Retais/epidemiologia , Neoplasias do Colo Sigmoide/epidemiologia , Adenocarcinoma/complicações , Adolescente , Adulto , Adulto Jovem , Colonoscopia , Estudos Retrospectivos , Estudos Transversais , Feminino , Humanos , Masculino , Neoplasias Retais/complicações , Neoplasias do Colo Sigmoide/complicações , Pessoa de Meia-Idade , PrevalênciaRESUMO
After six years experience in the anatomopathological study and having checked 33.452 histological cases 772 corresponded to colon tumoral pathology. It was then decided to proceed with the epidemiological analysis of the polyps, it's anatomical distribution according to sex and age, it's histolopathological characteristics and the possible relationship with malignant transformation. We found a clear predominance mainly of adenomatosic neoplasic polyps, followed by hyperplasic polyps. 65% of the patients were male and more than half of the cases were between the ages of 50 and 70. Coincitentally, 86% of the atypical polyps were found within this age group.
Assuntos
Adenoma Viloso/epidemiologia , Pólipos Adenomatosos/epidemiologia , Pólipos do Colo/epidemiologia , Adenoma Viloso/patologia , Pólipos Adenomatosos/patologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Pólipos do Colo/patologia , Feminino , Humanos , Hiperplasia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/epidemiologia , Neoplasias Retais/patologia , Distribuição por Sexo , Neoplasias do Colo Sigmoide/epidemiologia , Neoplasias do Colo Sigmoide/patologia , Venezuela/epidemiologiaRESUMO
Colonoscopic polypectomy is an important therapeutic advance as it enables most colonic polyps to be removed entirely and studied pathologically and has virtually replaced surgical treatment. The clinical and pathological features of patients with colonic polyps treated by colonoscopic polypectomy over a five-year period are reported. Seventy-four patients (37 men, 37 women) with a mean age of 57 years had 109 polyps removed by snare polypectomy. Rectal bleeding was the predominant symptom and was present in 63.5%. Lower abdominal pain was present in 12%. The majority of polyps were located in the sigmoid (38.5%) and descending (40.3%) colon. Ninety-five polyps were pedunculated and 14 were sessile. Of the neoplastic polyps, 61.6% were pure tubular adenomas, 25.2% were mixed tubulo-villous adenomas and 1% were pure villous adenomas. There were no complications arising from colonoscopy or snare polypectomy. Colonoscopic polypectomy is a safe, reliable and cost-effective therapeutic procedure that has revolutionized the management of pre-cancerous neoplastic colonic polyps.
Assuntos
Carcinoma/cirurgia , Neoplasias do Colo/cirurgia , Pólipos do Colo/cirurgia , Adenoma/epidemiologia , Adenoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/epidemiologia , Neoplasias do Colo/epidemiologia , Pólipos do Colo/epidemiologia , Colonoscopia , Feminino , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias do Colo Sigmoide/epidemiologia , Neoplasias do Colo Sigmoide/cirurgiaRESUMO
Em 25 anos, entre 1965 e 1990, tivemos a oportunidade de seguir 43 pacientes portadores de câncer colorrectal, com idades inferiores a 40 anos, até a morte pela doença ou até a sobrevida de 5 anos, e mesmo além deste período. Embora seja uma doença prevalente em pacientes mais velhos, 43(6,9%) pacientes com menos de 40 anos foram estudados dentro de uma casuística geral de 620 casos de câncer colorrectal, durante este período. As idades variaram entre 17 e 39 anos, com média de 32.8 anos. Onze pacientes tiveram o câncer associado a retocolite ulcerativa grave (3), polipose familiar (2) ou pólipos isolados (6). Os sintomas mais comuns foram sangramento retal (72,1%), alteraçöes do ato defecatório (58,1%), dor e desconforto abdominais (54,5%), aumento do ritmo dos movimentos intestinais (51,1% e perda de peso corporal em 29 casos. Em 80% dos pacientes os tumores localizavam-se no reto e no sigmóide. Em 32 pacientes (74,4%) os sintomas tinham menos de 3 meses de evoluçäo. A amputaçäo abdominoperineal foi a operaçäo mais realizada (32,5%), seguindo-se retossigmoidectomia (18,6%) e colectomia direita (14,0%). Sob o prisma histopatológico, o grupo A de Dukes foi observado em três (7,0%), o grupo B em 16(37,2%), o grupo C em 19 pacientes (44,2%) e, em 5 casos (11,6%), foram observadas metástases em outros órgäos. Todos os tumores estudados eram adenocarcinomas, sendo cinco (14,3%) bem diferenciados, 17 (48,2%) moderadamente diferenciados e 13 (37,1%) pobremente diferenciados. A sobrevida de 5 anos foi de 100% para o grupo A, 71,4% para o grupo B, 14,3% para o grupo C e 0% para o grupo D. Os fatores que mais contribuíram para piorar o prognóstico dos pacientes foram os grupos C e D de Duckes, a baixa diferenciaçäo histológica dos tumores e o componente mucinoso dos mesmos. Fatores como tempo e sintomas, tamanho e localizaçäo dos tumores, quimio e/ou radioterapia complementares näo influenciaram de forma significativa a taxa de sobrevida de 5 anos. Chegamos entäo à conclusäo de que o câncer colorretal em pacientes com idades inferiores a 40 anos apresenta prognóstico pobre, em grande parte devido à baixa diferenciaçäo tumoral
Assuntos
Adolescente , Adulto , Humanos , Masculino , Feminino , Adenocarcinoma/epidemiologia , Adolescente , Adulto , Neoplasias do Colo Sigmoide/epidemiologia , Neoplasias Retais/epidemiologiaRESUMO
Reportes recientes ha indicado una migración proximal en la localización de cáncer de intestino grueso. Un análisis de 163 casos en el Centro Médico San Pablo durante el período de 1980-86 reveló un aumento en las lesiones del lado derecho. En la mayoría de los casos la patología demostró invasión de la pared intestinal (Duke's C). Estos hallazgos deben ser dirigidos hacia el cernimiento del intestino grueso en su totalidad y no hacia el lado izquierdo como tradicionalmente se realizaba