La technique de la colonofibroscopie

Summary

Four hundred patients were studied wit 485 examinations by colonofiberscopy. It was found that any type of colonofiberscope would pass the upper part of the sigmoid colon in almost every patient except thosewith advanced carcinoma. After passing the fiberscope through the sigmoid colon, there are three difficult places through which the fiberscope must pass ; the junction between the sigmoid colon and descending colon, the splenic flexure, and the mid-transverse colon to the hepatic flexure. Passage through the junction between the sigmoid colon and the descending colon was solved completely by using the 180 degrees counter-clockwise rotation method. After passing through there the fiberscope has to be intentionally rotated 180 degrees clockwise direction to release the sigmoid loop and make a straight course. The inserting force is directed to the tip of the fiberscope. Occasionally, after the fiberscope has reached the splenic flexure, further insertion is impossible due to an acute flexure of the colon and flexibility of the fiberscope. Passage through the splenic flexure was often solved by using a steel wire and/or a stiffening tube. In patients studied for the purpose of examining the cecum, a success rate of moret han 40 per cent was obtained. This procedure is very useful for preoperative diagnosis, cautery-snare rescetion, and careful long-term follow-up studies. It is also advisable for the determination of medical inflammatory changes, for the determination of surgical procedures of neoplasms, and to help to decrease the number of unnecessary laparotomies. Specifications for these colonofiberscopes, therapy for examination technics, and ome points of improvement are presented. A cooperative underastnd-ing from the radilolgy department which provides fluoroscopic assistance is necessary to ensure safety during the procedure : fluoroscopy permits observation of the position of the fiberscope, and facilitates its insertion, withdrawal, and rotation.