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Inicio Gastroenterología y Hepatología Distribución de la enfermedad polipoidea en la comarca interior de Vizcaya: imp...
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Vol. 26. Núm. 7.
Páginas 401-406 (enero 2003)
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Vol. 26. Núm. 7.
Páginas 401-406 (enero 2003)
Acceso a texto completo
Distribución de la enfermedad polipoidea en la comarca interior de Vizcaya: implicación en pruebas diagnósticas y cribado del cáncer colorrectal
Distribution Of Polyps In The Inside Region Of Vizcaya (Spain): Implications For Diagnostic Tests And Colorectal Cancer Screening
Visitas
4126
B. Velayos Jiméneza,
Autor para correspondencia
benitovelayos@hotmail.com

Correspondencia: Dr. B. Velayos Jiménez. Vallespín, 11, 1o. 05001 Ávila. España.
, M. Durán Rigueiraa, J.A. Arévalo Sernaa, I. Heras Martína, A. Bernal Martíneza, F. Pons Renedob, J.L. Cabriada Nuñoa
a aServicio de Aparato Digestivo. Hospital de Galdácano. Vizcaya. España
b Unidad de Aparato Digestivo. Hospital Sierrallana. Torrelavega. Cantabria. España
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Bibliografía
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Estadísticas
Introducción

La relevancia de los pólipos colónicos cada día es mayor por ser el hallazgo en que se basa el cribado del cáncer colorrectal (CCR). Sin embargo, este cribado está lejos del consenso en cuanto a las técnicas que deben emplearse: se compara la colonoscopia frente a otros métodos, como la sigmoidoscopia, que sólo explora con buena sensibilidad los tramos distales del colon. Hemos estudiado las características y la topografía de la enfermedad polipoidea en nuestro medio con el objetivo de verificar la tendencia al cambio en su localización y las implicaciones en el cribado que esto conlleva.

Material Y Metodos

Se revisó la prevalencia y las características de los pólipos colónicos en 3.604 pacientes que por algún motivo acudieron para que se les practicara una colonoscopia en nuestro servicio, así como su distribución en los 837 pacientes con diagnóstico de pólipos y colonoscopia completa. Analizamos su situación proximal o distal al ángulo esplénico y su tamaño (< o ≥ 1 cm).

Resultados

Se encontraron pólipos en el 28,3% de los 3.604 pacientes (en el 11,7% si consideramos los ≥ 1 cm). En un 44,9% de los 837 pacientes con colonoscopia completa había pólipos proximales (14,6% para los ≥ 1 cm), mientras que en un 79,9% se observaron en el colon distal (un 30,3% al valorar los ≥ 1 cm). Un 24,8% de los pacientes los presentaba en ambas localizaciones. La probabilidad de encontrar una lesión proximal si existía una distal se situó en el 31%. En un 20% de los casos existía algún pólipo proximal sin lesión distal (un 5,6% para los ≥ 1 cm), por lo que la sigmoidoscopia perdería el 15,6% de los pólipos ≥ 1 cm.

Conclusiones

Un porcentaje relativamente elevado de pacientes con pólipos proximales ≥ 1 cm quedarían sin diagnosticar si sólo se hiciera una colonoscopia completa a los que presentaban pólipos distales. Debido a la notoria y progresiva mayor frecuencia de pólipos proximales y al relevante número de ellos que se presenta sin lesión centinela distal, cada vez hay más argumentos para considerar la colonoscopia como la técnica fundamental para el cribado del CCR.

Introduction

The importance of colonic polyp is increasing because colorectal cancer (CRC) screening is based on their identification. However, consensus is lacking on which technique should be used in CRC screening, whether colonoscopy or other methods such as sigmoidoscopy, which shows good sensitivity only in distal segments of the colon. We studied the characteristics and localization of polyps in our environment to verify their tendency to change localization and determine the implications of this in screening.

Material And Methods

We reviewed the prevalence and characteristics of colonic polyps in 3604 patients who underwent colonoscopy for various causes in our service, as well as their distribution in 837 patients with a diagnosis of polyps who underwent complete colonoscopy. Localization proximal or distal to the splenic flexure and polyp size (less than or more than 1 cm) were analyzed.

Results

Polyps were found in 28.3% of 3604 patients (11.7% showed polyps ≥ 1 cm). Of the 837 patients who underwent complete colonoscopy, proximal polyps were found in 44.9% (14.6% showed polyps ≥ 1 cm), while distal polyps were found in 79.9% (30.3% showed polyps ≥ 1 cm). Both proximal and distal polyps were found in 24.8%. The probability of finding both proximal and distal lesions was 31%. Proximal lesions without distal lesions were found in 20% of the patients (5.6% presented polyps ≥ 1 cm), and consequently sigmoidoscopy would miss 15.6% of polyps ≥ 1 cm.

Conclusions

A relatively high percentage of patients with proximal polyps ≥ 1 cm would remain undiagnosed if complete colonoscopy were only performed in patients with distal polyps. Because of the well-known increase in the frequency of proximal polyps and because a considerable number of these present without distal sentinel lesions, there are increasing arguments for considering colonoscopy as the basic technique for CRC screening.

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Copyright © 2003. Elsevier España, S.L.. Todos los derechos reservados
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