Eleodoro Carlos de Almeida

Câncer de cólon: como diagnosticá-lo? Trabalho prospectivo

PURPOSE: Analyze the profile of colon and rectal cancer. METHODS: 390 colonoscopies were performed in 152 asymptomatic people Group A and 238 colon cancer patients with diagnosis done at colonoscopy Group B. Age, family history (FH), symptoms, Body Mass Index (BMI), location of the tumor and histopathology were analyzed. P value 0,95. 79 patients (31%) of cancer had positive FH and positive FH was present in 34 patients without cancer (23%) P>0,05.BMI was 26+/-4 Group A and 27+/- for B P>0,05 9 patients (5,9%) from Group A was found to have cancer. Superficial in 1 (11%) Group A against 21 (8,8%) for Group B P>0,05. Change of bowel habits with bleeding was 56 (60%) on the left colon cancer against 13 (31%) on the right P<0,01. Weight loss and anemia occurred more frequently on the right when compared to the left 30 (44%) X 31 (17%) and 36 (46%) X 15 (8%) P<0,01. 157 patients (63%) had symptoms for more than 6 months. Moderated-differentiated adenocarcinoma was found in 166 (67%), well-differentiated 63 (25%) and poorly-differentiated in 18 (7%) of the patients. CONCLUSION: The profile of CRC must be better studied.

Índice de massa corpórea, obesidade abdominal e risco de neoplasia de cólon: estudo prospectivo

Objetivo: Investigar a associacao do excesso de peso e da obesidade abdominal como fator de risco para câncer colorretal/adenoma CCR/Ad. Pacientes e Metodos: De janeiro de 2007 a dezembro de 2008, 1287 pacientes com idade igual ou superior a 50 anos, sem fatores de risco para CCR, foram submetidos a colonoscopia total e avaliados quanto ao indice de massa corporea IMC e razao cintura quadril RCQ. Teste t de Student foi usado para estudo da media e qui-quadrado para analise de numeros absolutos. P menor que 0,05 foi considerado significativo. Resultados: Neoplasia foi encontrada em 542 (42,1%), sendo 231 (50,7%) homens e 311 (37,3%) mulheres. IMC > 30 ocorreu em 43 (18,6%) de CCR/Ad masculino e 84 (27%) feminino P> 0,05. Em 188 (49,4%) homens com IMC 0,05. RCQ foi de 0,96±0,05 cm para homens com tumor e 0,94±0,07 sem tumor P< 0,01. Nas mulheres RCQ foi de 0,89±0,06 com tumor para 0,88±0,06 sem tumor P< 0,05. Conclusoes: IMC nao esta associado a neoplasia de colon, porem a obesidade abdominal seria fator de risco.

Colonoscopia com polipectomia: análise crítica de fatores de risco e complicações

Purpose: The aim of this study was to evaluate adverse events from snare polypectomy. Methods: We retrospectively analysed the rate of complications of 1687 snare polypectomies carried out in 8447 colonoscopies between 2001 and 2007 at two Medical Institutions. Student t test was used for statistical analysis of mean and chi-square to compare absolute numbers. A significant p-value was defined as 0,05.Post-polypectomy syndrome occurred in 6 patients (0,35%). In polyps larger than 2 cm, piecemeal resection was performed more often in sessile than in pedunculated ones 89/116 ( 77%) versus 11/87 (13%) p<0,01. Invasive carcinoma was present in 40 adenoma larger than 2 cm (19,7%). Conclusion: Snare polypectomy is safe procedure, being bleeding the most common complication, related with polyp size mainly its base, treated most of the time endoscopically. Perforation being the next, treated too without surgery.