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      Aderência ao controle colonoscópico nos pacientes submetidos à ressecção endocóspica de adenomas Translated title: Colonoscopic control adherence in patients submitted to endoscopic adenoma resection

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          Abstract

          OBJETIVOS: Analisar a aderência de pacientes ao controle colonoscópico após ressecção endoscópica de pólipos adenomatosos. PACIENTES E MÉTODOS: Foram avaliados 74 pacientes que realizaram colonoscopia e apresentaram pólipos adenomatosos. Estes indivíduos foram orientados a realizar colonoscopia de controle após 1 ano, de acordo com o número de adenomas, diâmetro e classificação histológica. Além da orientação na consulta, os pacientes foram avisados por ligação telefônica no período indicado para colonoscopia de controle. RESULTADOS: No período de outubro de 2000 até abril de 2006 foram acompanhados 74 pacientes. Destes 51% eram do sexo masculino, sendo que a idade média foi de 52 anos. A aderência à colonoscopia de controle neste grupo foi de 82 %, sendo que no sexo feminino foi de 94% e no masculino, de 71%, demonstrando diferença estatisticamente significante (P= 0,023). Quanto à faixa etária, não houve diferença estatística entre os grupos, porém com uma tendência a menor aderência no grupo acima de 60 anos que poderá ser confirmada com aumento da amostra. CONCLUSÃO: Devido à recorrência de pólipos adenomatosos após a primeira polipectomia, está indicado o acompanhamento periódico desses pacientes. A colonoscopia, acompanhada de polipectomia das lesões adenomatosas, é a melhor ferramenta para a prevenção do câncer colorretal nestes indivíduos. Este trabalho demonstra que pacientes do sexo masculino possuem uma menor aceitação ao acompanhamento endoscópico, estando indicadas neste grupo medidas que promovam uma maior aderência a este tipo de prevenção.

          Translated abstract

          OBJECTIVES: To analyze the patients' adherence after endoscopic resection of polyps with adenomas. PATIENTS AND METHODS: 74 patients who have been undergone to colonoscopy and have presented polyps with adenomas were evaluated. These patients have been oriented to do colonoscopy control which has varied in time according to the number of adenomas, diameter and histological classification. Besides the appointment orientation, the patients have been informed through phone calls during the period indicated for colonoscopy control. RESULTS: From October 2000 to April 2006, 74 patients have been followed, 51% of them were male and the average age was 52. The adherence to colonoscopy control in this group has been 82%, among the female group 94% and in the male 71%, showing a significant statistical difference (P< 0,05). In relation to the age range there has not been statistical difference among the groups, however, with a tendency to a minor adherence in the group over 60 which could be confirmed with the sample increase. CONCLUSION: Due to the polyps with adenomas recurrence after the first polypectomy, it has been indicated to these patients periodical follow up. Colonoscopy followed by polypectomy of the adenomas injuries has been the best tool for the colorectal cancer prevention in these subjects. This study demonstrates that male patients have got a minor acceptance to endoscopic follow up, indicating measures that promote a major adherence of that group to this kind or prevention.

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          Quality indicators for colonoscopy.

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            Patterns of endoscopic follow-up after surgery for nonmetastatic colorectal cancer.

            Endoscopic examinations of the colon are often recommended for surveillance following colorectal cancer resection. The actual use and outcome of this testing are not known. Five thousand seven hundred sixteen patients 65 years of age or older with local or regional stage colorectal cancer diagnosed in 1991 were identified through the Surveillance Epidemiology and End Results registry. All inpatient and outpatient Medicare claims from 6 months after diagnosis through the end of 1994 were examined to determine use of endoscopic procedures. One or more colonoscopies were performed in 51%, with an average of 2.9 procedures performed among those tested; sigmoidoscopy was performed in 17%. The rate of colonoscopy was highest during the initial 18 months. Polypectomy was performed in 21% of all patients, and subsequent primary colorectal tumors were diagnosed in 1.3%. Factors associated with colonoscopy and sigmoidoscopy use included younger age, survival through follow-up, and geographic region; sigmoidoscopy was also more common in relation to rectal cancers. There is variability in the use of endoscopic procedures following potentially curative resection for colorectal cancer, with patient-related factors and local practice patterns accounting for the variation. Further studies are needed to elicit the reasons for lack of follow-up and adherence to practice guidelines.
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              Predicting adherence to colonoscopy or flexible sigmoidoscopy on the basis of physician appointment-keeping behavior.

              Poor patient attendance to scheduled flexible sigmoidoscopy or colonoscopy may contribute to deficient colorectal cancer screening.
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                Author and article information

                Journal
                rbc
                Revista Brasileira de Coloproctologia
                Rev bras. colo-proctol.
                Cidade Editora Científica Ltda (Rio de Janeiro, RJ, Brazil )
                0101-9880
                September 2006
                : 26
                : 3
                : 249-252
                Affiliations
                [01] orgnameUEM
                [02] RS orgnameUniversidade de Caxias do Sul BRASIL
                Article
                S0101-98802006000300004 S0101-9880(06)02600304
                ee484316-af24-4107-8e39-bfe806dc5d85

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 01 August 2006
                : 10 May 2006
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 7, Pages: 4
                Product

                SciELO Brazil

                Categories
                Artigos Originais

                prevenção,adenomas,polypectomy,aderência,colonoscopy,prevention,Adherence,polipectomia,colonoscopia

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