Colonoscopic detection of early XXXX . Impact of a surgical endoscopy service.

@entity1 @entity5 @entity75 @entity344 @entity14
The Surgical Endoscopy Service has been aggressively evaluating @entity344 with colonoscopy and screening asymptomatic @entity1 with flexible sigmoidoscopy in hopes of finding early curable @entity14 . The purpose of this study was to compare the stages of @entity14 resected during the 18-month period prior to (Pre-SES) and during the first 18 months (Post-SES) after the creation of the Surgical Endoscopy Service. In addition, the yield of lesions that would have been obtained by depending upon @entity1 symptoms or occult blood testing were determined. A total of 361 colonoscopies were performed Pre-SES and 874 colonoscopies Post-SES; 26 @entity1 underwent resection of @entity14 Pre-SES and 32 Post-SES. Whereas early @entity14 (Dukes' A and B1) were found in only three @entity1 (12%) Pre-SES period, early @entity5 were found in 13 (41%) Post-SES. Doubling the number of colonoscopies produced a fourfold increase in the number of @entity75 . Furthermore, disseminated @entity5 (D lesions) dropped from 19% Pre-SES to 3% Post-SES. Among the total 58 @entity1 , 43% of the A lesions and 40% of the B1 lesions were asymptomatic. Even more alarming, 86% of the A lesions, 50% of the B1 lesions, 31% of the B2 lesions, and 14% of the C2 lesions were occult blood negative. Indeed, only the D lesions were uniformly occult blood positive. This study demonstrates that aggressive colonoscopy detects early @entity14 . Moreover, @entity1 symptoms or occult blood testing will fail to indicate the majority of early @entity14 .
