• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Doctoral Thesis
DOI
https://doi.org/10.11606/T.5.2020.tde-16062021-123001
Document
Author
Full name
Alexandre Gomes
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2020
Supervisor
Committee
Jukemura, José (President)
Borghesi, Ronaldo Antonio
Franzini, Tomazo Antonio Prince
Moura, Eduardo Guimarães Hourneaux de
Title in Portuguese
Videoanuscopia: resultados do exame anal de rotina durante as colonoscopias
Keywords in Portuguese
Canal anal
Colonoscopia
Proctoscopia
Abstract in Portuguese
INTRODUÇÃO: O exame anal e a videoanuscopia (VA) raramente são realizados durante as colonoscopias. É recomendado o exame do canal anal e região perianal durante a colonoscopia de rotina, principalmente para detecção de neoplasias e na pesquisa do sangramento anorretal. A anuscopia, que é considerada de grande importância para a detecção de doenças anais e perianais, tem sido esquecida nesta era da videocolonoscopia. OBJETIVO: O objetivo deste estudo é demonstrar que o exame anal e a VA fornecem informações importantes e devem ser feitos em todas as colonoscopias de rotina. MÉTODOS: Um estudo retrospectivo descritivo foi realizado em 12151 pacientes rastreados por VA, que foram realizados durante a colonoscopia ambulatorial de rotina entre 2006 e 2018. Os aspectos estudados foram: exame normal; hemorroidas; hemorroidas trombosadas; fissura anal; doença de Crohn perianal; fístula perianal; condiloma; pólipos; neoplasias; estenose anal; sangramento e outros achados. Foram calculadas as porcentagens de cada achado e subdivididos em faixas etárias a cada dez anos, separadamente por sexo, além da mediana e a média de idade. RESULTADOS: Das colonoscopias realizadas em 12151 pacientes, 9364 casos (77,06%) apresentaram algumas alterações. Hemorroidas internas grau I (5911 - 48,65%); hemorroidas internas dos graus II, III e IV (2362 - 19,44%); hemorroidas trombosadas (120 - 0,99%); sangramento (56 - 0,46%); fissura (415 - 3,42%); fístula perianal (42 - 0,35%); doença de Crohn perianal (34 - 0,28%); condilomas (18 - 0,15%); estenose anal (30 - 0,25%); outros achados (310 - 2,55%); pólipos (62 - 0,51%); quatro casos de neoplasia do canal anal (0,03%): dois casos de carcinoma espinocelular e dois casos de adenocarcinoma. CONCLUSÃO: A realização da videoanuscopia de rotina durante a colonoscopia melhorou o diagnóstico das lesões anais neoplásicas, permitiu a correta classificação do grau das hemorroidas, ajudou a confirmar o local do sangramento e detectou outras patologias anais. Os principais achados foram hemorroidas, fissuras e fístulas perianais. O estudo propõe que o exame anal e a VA devam ser realizados em todas as colonoscopias de rotina
Title in English
Video anoscopy: results of routine anal examination during colonoscopies
Keywords in English
Anal canal
Colonoscopy
Proctoscopy
Abstract in English
BACKGROUND: Anal examination and video anoscopy (VA) are rarely performed during colonoscopies. Examination of the anal canal and perianal region is recommended during routine colonoscopy, especially for cancer detection and for anorectal bleeding. Anoscopy, which is considered of great importance for the detection of anal and perianal diseases, has been forgotten in this era of video colonoscopy. STUDY AIMS: The aim of this study is to demonstrate that anal examination and VA provide important information in all routine colonoscopies. METHODS: A cross-sectional study was conducted on 12,151 patients screened by VA which were performed during routine outpatient colonoscopy between 2006 and 2018. The aspects studied were: normal examination; hemorrhoids; thrombosed hemorrhoids; anal fissure; perianal Crohn's Disease; perianal fistula; condyloma; polyps; neoplasms; stenosis; bleeding and other findings. The percentages of each finding were calculated and subdivided into age groups every ten years, separately by gender, as well as median and average age. RESULTS: Of the colonoscopies performed on 12,151 patients, 9364 cases (77.06%) presented some alterations. Internal I degree hemorrhoids (5911 - 48.65%); internal hemorrhoids of II, III and IV degrees (2362 - 19.44%); thrombosed hemorrhoids (120 - 0.99%); bleeding (56 - 0.46%); fissure (415 - 3.42%); perianal fistula (42 - 0.35%); perianal Crohn's Disease (34 - 0.28%); condylomas (18 - 0.15%); anal stenosis (30 - 0.25%); other findings (310 - 2.55%); polyps (62 - 0.51%), one of which was adenomatous with high-grade dysplasia; four cases of anal canal neoplasia (0.03%): two cases of squamous cell carcinoma and two cases of adenocarcinoma. CONCLUSION: The association of routine video anoscopy during colonoscopy improved the diagnosis of the neoplastic anal lesions, allowed correct classification of the degree of hemorrhoids, helped to confirm the bleeding site and detected other anal pathologies. The main findings were hemorrhoidal diseases, fissures and perianal fistulas. The study suggests that VA should be used in all colonoscopies
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
AlexandreGomes.pdf (35.70 Mbytes)
Publishing Date
2021-06-24
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2022. All rights reserved.