This is the 3674th article of Da Medical Care
"Alas, it's time to go to colonoscopies on a regular basis, and I really don't want to go!" However, because I have a family history of bowel cancer, I am not at ease if I do not check it.
Colonoscopy isn't that scary, is it? It's really not okay to do it painlessly.
Yes, as long as you overcome the embarrassment of taking off your pants and exposing your ass, and you really can't stand the feeling of swelling when doing colonoscopy, you won't be able to use an anesthetic. But......
What's so scary about that?
Don't tell you, I think the most painful part of colonoscopy is the preparation of the intestines in the early stages! The pain of getting up in the middle of the night to drink intestinal cleansing medicine is really uncomfortable. Drink water until you want to throw up, and you have to defecate until only clear water remains.
The most frightening thing is to toss and turn for half a day, and tell you when doing colonoscopy:
Poor preparation of the intestines, poor quality of examinations ...
That's right! That was so frustrating. It seems that you have experienced it too! Is there a colonoscopy that is less painful and can be examined?
You can try the CTC virtual colonoscopy without intubation and pants off, which is not so demanding for colon cleansing.
dummy? Fake! Can you see that?
Colorectal cancer is a common malignant tumor of the digestive tract in today's society, according to statistics, in 2020, China will become the country with the highest number of colorectal cancer cases in the world! On the mainland, colorectal cancer accounts for the second highest number of new cases of all cancers and the fifth highest number of deaths. Although the incidence of bowel cancer has gradually increased in recent years, it is recognized as the most preventable, the most detectable, and the most treatable cancer.
We know that colonoscopy is the gold standard for the detection of intestinal diseases, especially for early bowel cancer screening, which is of great significance. However, due to the not-so-wonderful examination experience, the unpleasant experience of drinking intestinal cleansing pills, and the embarrassment of exposing your ass, many people are discouraged from colonoscopy. As soon as the colonoscope was mentioned, I was so frightened that I delayed the disease. For patients who cannot tolerate colonoscopy, CT simulation endoscopy (CTC) in imaging can be tried.
CT simulated colonography (CTC), also known as simulated colonoscopy or virtual colonoscopy, is a safe, non-invasive method of colon examination. CTC is an ideal alternative when the screener is unable or unwilling to undergo colonoscopic screening. In short, the multi-layer spiral CT is first used for supine and prone thin layer scanning of the whole colon, and the data obtained by photography is processed and then compiled, and three-dimensional reconstruction is carried out to generate three-dimensional images of the intestine, and to check for potential lesions. Clinically, it is mainly used for colon and rectal cancer screening, supplementary examination after colonoscopy is not completed, colonoscopy is contraindicated or unwilling to accept colonoscopy, and the diagnosis and staging of colon and rectal cancer.
merit
1. Compared with colonoscopy, the risk of complications such as intestinal bleeding and intestinal perforation is low.
2. Intestinal cleansing requirements are not high, although this test also needs intestinal cleansing, but only a small amount of intestinal cleansing drugs and a little developer, do not need to be as traditional colonoscopy as the intestinal tube must be completely cleaned, nor do you need to swallow so many laxatives.
3. There are no obvious contraindications, especially for patients who cannot tolerate colonoscopy such as advanced age and weakness, cardiopulmonary insufficiency, etc.; the whole colon can be detected, including the proximal intestinal tube that cannot be passed by the colonoscopy due to intestinal narrowing, providing important diagnostic data for patients with low intestinal obstruction to determine the cause and location of obstruction before surgery; the inconvenience of colon cleaning caused by ostomy after colorectal cancer surgery, etc., this examination is more advantageous.
4. The examination time is short, convenient and painless, and the subject does not need recovery time after the examination and can immediately move normally.
5. The data obtained by CTC after filming is processed by the computer image and becomes a very three-dimensional and vivid three-dimensional picture. Like traditional colonoscopy, CTC can clearly show what your intestines look like, and there are almost no dead ends: traditional colonoscopes can only look in a single direction when walking in the intestine, so the inside of the intestinal folds is easy to become an overlooked dead angle, and the inside of the intestinal wall folds on CTC examination is also difficult to escape. Data show that for polyps larger than 6 mm, CTC detection has a high sensitivity and specificity.
6. CTC can also detect some extraintestinal lesions.
shortcoming
1. CTC is a virtual image, which cannot show the true color of the intestinal mucosa, nor can it observe the subtle changes in blood vessels and mucous membranes.
2. The ability to recognize shallow concave, slightly long and flat lesions is poor; lesions below 5mm, or the lesion itself is not largely uplifted, or the flat lesion that has to be used as an important judgment clue by the difference in mucous membrane color cannot be judged, which is incomparable with traditional colonoscopy.
3.3D imaging is only an indirect observation of the lesion, and the specimen cannot be taken for pathological diagnosis or treatment;
4. There is radiation damage, but its radiation dose is very small, equivalent to doing an X-ray barium meal contrast, no need to worry at all.
5. Higher fees. At present, the method is not widely used in the mainland, but the tertiary hospitals in many cities have gradually carried out the project, which can be consulted.
The limitations of CTC are obvious and cannot completely replace traditional colonoscopy, but for those who are really reluctant to do colonoscopy, combining fecal occult blood testing (chemical and immunological methods), fecal DNA testing and other means can also be used as a means of early cancer screening. However, if you want to find early cancer and precancerous lesions earlier, such as adenomatous polyps, polyps smaller than 5mm, flat lesions, etc., traditional colonoscopy is more reliable.
In Europe and the United States and other countries CTC examination research has been more in-depth many years, is considered to be comparable to the traditional colonoscopy of the bowel cancer screening method, the latest bowel cancer screening guidelines in the United States also clearly stipulate that it can be used as a screening method. When screening subjects are unable or unwilling to undergo colonoscopic screening, CT simulation endoscopy (CTC) is an ideal alternative. At present, although this inspection is not as popular in China as in Western developed countries, it is expected to be the trend in the future.
Author: Department of Surgery, East China Sanatorium
Zhou Lu Attending Physician