양성 직장항문 질환에서의 대장 내시경검사의 의의
Clinical Significance of Colonoscopy in Patients with Benign Anorectal Disease
김경보, 박현철, 오재환,
소속 상세정보
김경보 ( Kim Kyung-Bo )
가천의과학대학교 길병원 외과학교실
박현철 ( Park Hyun-Chul )
가천의과학대학교 길병원 소화기내과
오재환 ( Oho Jae-Hwan )
가천의과학대학교 길병원 외과학교실
KMID : 0356720010170040181
Abstract
Purpose: Benign anorectal disease will often cause great concern to the patient and the practitioner about a more proximal colon pathology. The aim of this study is to evaluate the significance of routine colonoscopy for patients with benign anorectal disease.
Methods: A retrospective analysis of 108 patients with benign anorectal disease who had undergone colonoscopic examination from April 1997 to August 1998 at Gil Medical Center was done.
Results: The mean age of all patients was 43 years; the male-to-female ratio was 1：1.1. The diagnoses of anorectal disease were hemorrhoids in 84 cases, anal fissures in 13 cases, chronic anal pain syndrome in 6 cases, anorectal fistulas in 5 cases, and other in 9 cases. There were 37 patients (34.3%) with 53 abnormal findings: 14 tubular adenomas, 11 inflammatory polyps, 4 hyperplastic polyps, 1 tuberculous colitis, 1 angiodysplasia, 6 diverticula, 6 nonspecific ileitis or colitis, 2 melanosis coli, 2 rectal ulcers, 2 ileal ulcers, and 3 other diseases. Among them, clinically significant lesions, such as neoplastic lesion, tuberculous colitis and angiodysplasia, were detected in 12 patients (11.1%). Because the lesions in 7 patients of the 12 patients were within the reach of sigmoidoscopy, only 5 patients (4.6%) needed a colonoscopic examination. In regard to neoplasms, patients presenting with anal bleeding and old age were not found to have a higher frequency of neoplasia. Also, the specific type of anorectal disease was not associated with an increased risk for colorectal neoplasia (P＞0.05).
Conclusion: Sigmoidoscopy is a more acceptable primary diagnostic tool in patients with benign anorectal disease, but in patients with gastrointestinal symptoms, a high risk for colorectal cancer, suspicious inflammatory bowel disease, or fear of cancer, selective colonoscopy will be needed.
키워드
양성 직장 항문 질환;대장 내시경검사
Benign anorectal disease;Colonoscopy
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