What question did this study set out to answer?

To evaluate whether total colonoscopy should replace preliminary radiology (rigid sigmoidoscopy plus double contrast barium enema) as the initial investigation for suspected colonic disease.

January 16, 1988BMJOpen Access

Should colonoscopy be the first investigation for colonic disease?

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Authors

DLDavid C. LindsayUniversity of London JFJan FreemanUniversità Cattolica del Sacro Cuore ICI CobdenNorthumbria Healthcare NHS Foundation Trust

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Implication

Randomized trial reveals fewer secondary investigations with initial colonoscopy compared to barium enema in colonic disease, indicating colonoscopy may be preferred initially.

Key Points

To evaluate whether total colonoscopy should replace preliminary radiology (rigid sigmoidoscopy plus double contrast barium enema) as the initial investigation for suspected colonic disease.
Randomized trial allocating 168 patients requiring large bowel evaluation to either rigid sigmoidoscopy plus double contrast barium enema (n=89) or total colonoscopy (n=79).
Pathology was diagnosed in 56 patients, including 14 with carcinoma, 11 with polyps, 16 with inflammatory bowel disease, and 15 with isolated diverticular disease.
In the barium enema arm, 24 of 89 patients required subsequent colonoscopy (9 for suspected polyps/tumor, 3 for incomplete exams, 12 for unexplained rectal bleeding), which altered treatment or yielded new findings in 16 patients.
In the colonoscopy arm, only 6 of 79 patients required subsequent radiology, and both approaches demonstrated good tolerability with no major complications reported.

Cite This Study

Lindsay et al. (1988) studied this question.

synapsesocial.com/papers/6a709f1fe71d69abee08bc1e https://doi.org/10.1136/bmj.296.6616.167

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Implication

Randomized trial reveals fewer secondary investigations with initial colonoscopy compared to barium enema in colonic disease, indicating colonoscopy may be preferred initially.

Should colonoscopy be the first investigation for colonic disease?

Discussion

Member takes

Implication

Key Points

Cite This Study

Should colonoscopy be the first investigation for colonic disease?

Discussion

Member takes

Implication

Key Points

Cite This Study

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