NHẬN XÉT, ĐÁNH GIÁ VỀ CHẨN ĐOÁN LÂM SÀNG, NỘI SOI VÀ GIẢI PHẪU BỆNH Ở BỆNH NHÂN CÓ POLYP ĐẠI TRỰC TRÀNG

Abstract

Objectives: Using endoscopy to screen, diagnose and treat colorectal polyps in order to contribute to reducing the incidence of colorectal cancer as well as treating patients with benign colon polyps. Subjects: Patients with symptoms of the lower gastrointestinal tract. Methods: A prospective, cross-sectional study at Nhat Tan hospital, An Giang province for 1 year (from October, 2020 to September, 2021). Results: 440 patients underwent endoscopy and found 113 patients with colorectal polyps (25,7%). Patients with lower gastrointestinal bleeding to colonoscopy accounted for 39,3% compared with no bleeding 16,4%, p < 0,05 with OR = 3,3 (CI 95%: 2,1- 5,1). The time of symptom appearance in people with polyps who came to colonoscopy early <6 months accounted for 67,6% compared with those without polyps 32,4%, p<0,05, with OR=0,13 (CI 95%, 0,06-0,30).The number of patients with only 1 polyp alone was 41 (36,3%), other patients had >2 polyps, on average 1 patient had 2 polyps. Location of polyps: 7 (6,2%) cases with many polyps scattered throughout the colon, 36 (31,9%) in the right colon and 70 (61,9%) in the left colon. The results of endoscopic polyp diagnosis showed that when compared with the "gold standard" method of pathologic examination, colonoscopy only achieved a very low sensitivity value (17,4%) and a negative predictive value calculated as 40%. Conclusion: Patients with polyps often come to endoscopy earlier with symptoms of gastrointestinal bleeding. Diagnosis by colonoscopy easily misses polyps with malignant potential and pathology is always the gold standard in the diagnosis of colorectal polyps.