Flexible sigmoidoscopy is an alternative to colonoscopy for investigating symptoms of a lesion of the rectum or left colon.
In this study, investigators from England evaluated flexible sigmoidoscopy as the main investigation for "left sided" colorectal symptoms.
The team evaluated the clinical records of 317 patients who were thought to have a lesion of the rectum or left colon were retrospectively reviewed.
All patients had flexible sigmoidoscopy as the primary investigation.
The investigators' primary outcome was the diagnostic yield of flexible sigmoidoscopy. Secondary outcomes were the need for additional colonic investigations, as well as failure and complication rates.
The team retrospectively analyzed 316 patients who had flexible sigmoidoscopy.
Of these, 8% had to be abandoned because of poor bowel preparation.
The examination was complete when it reached the splenic flexure. This occurred in 65% of the cases.
The team found that findings were normal in 43% of examinations.
|31% of the patients required an additional investigation.|
|Postgraduate Medical Journal|
There was a diagnosis of carcinoma of the rectum or colon in 9% of cases and 1 or more polyps in 18%.
The team calculated that 31% of the patients would require an additional investigation for further imaging of the right colon.
Dr Papagrigoriadis and colleagues concluded, "Although flexible sigmoidoscopy has a high yield of pathologies…the presence of those pathologies makes the full imaging of the whole colon with an additional investigation necessary".
"Therefore the cost efficiency of flexible sigmoidoscopy is questionable".
"Although flexible sigmoidoscopy is indicated for certain patients, it cannot replace colonoscopy as the main investigation used by a specialist colorectal clinic".