Zusammenfassung
Mit der Entwicklung der virtuellen Koloskopie als neuem Verfahren hat sich eine Alternative zur konventionellen Koloskopie ergeben. Die entstandene Konkurrenzsituation sollte positiv genutzt werden zur gegenseitigen Stimulation, aber auch zur Kooperation zwischen Endoskopiker und Radiologen. Die Herausforderung für die virtuelle Koloskopie besteht in der Weiterentwicklung der Untersuchungstechnik, um schnellere und genauere Ergebnisse zu erhalten. Die konventionelle Koloskopie sollte ihre bestehenden Stärken - Genauigkeit, Biopsie, Intervention - weiter fördern und gleichzeitig die Patientenakzeptanz durch schonendes Untersuchen und sinnvolle Medikation während der Untersuchung erhöhen. Gemeinsame Aufgabe zwischen Radiologen und Endoskopiker bestehen in der Evaluierung beider Methoden und in der Entwicklung differenzierter Untersuchungsstrategien.
Abstract
Advances in virtual colonoscopy have contributed to a new imaging modality as an alternative to conventional colonoscopy. This situation should stimulate competition as well as cooperation both of gastroenterologists and radiologists. The challenge for virtual colonoscopy includes the advancement of technology and computer capabilities in order to get faster and more precise results. Conventional colonoscopy should strengthen its existing advantages - sensibility, biopsy and interventional possibilities - and improve patient acceptance by considerate patient examination and rational medication during examination. Both, radiologists and gastroenterologists have to evaluate the two methods and establish diagnostic strategies.
Schlüsselwörter
Virtuelle Koloskopie - Konventionelle Koloskopie - Kolonkarzinomscreening
Key words
Virtual colonoscopy - Conventional colonoscopy - Colonic cancer screening
Literatur
1
Akerkar G A, Yee J, Hung R, McQuaid K.
Patient experience and preferences toward colon cancer screening: a comparison of virtual colonoscopy and conventional colonoscopy.
Gastrointest Endosc.
2001;
54
310-315
2
Farrell R J, Morrin M M, Silas A, Raptopoulos V, McGee J B.
Virtual colonoscopy in patients undergoing elective colonoscopy: diagnostic accuracy and patient tolerance [abstract].
Gastroenterology.
2000;
118
258
3
Fenlon H M, Nunes D P, Schroy P C, Barish M A, Clarke P D, Ferrucci J T.
A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps.
NEJM.
1999;
341
1496-1503
4
Hofstad B, Vatn M H, Andersen S N. et al .
Growth of colorectal polyps: redetection and evaluation of unresected polyps for a period of three years.
Gut.
1996;
39
449-456
5
Hixson L S, Fennerty M B, Sampliner F E, McGee D, Garewal H.
Prospective study of the frequency and size distribution of polyps missed by colonoscopy.
J Natl Cancer Inst.
1990;
82
1769-1772
6
Kay C L, Kulling D, Hawes R M. et al .
Virtual endoscopy: comparison with colonoscopy in the detection of space-occupying lesions of the colon.
Endoscopy.
2000;
32
226-232
7
Muto T, Bussey H JR, Morson B C.
The evolution of cancer of the colon and rectum cancer.
Cancer.
1975;
36
2251-2270
8
Pineau B C, Sevick M A, Mikulaninec C, Vining D J.
Evaluation of patient preference: virtual colonoscopy vs. endoscopic [abstract].
Gastroenterology.
1999;
116
484
9
Rembacken B J, Fujii T, Cairns A. et al .
Flat and depressed colonic neoplasm: a prospective study of 1 000 colonoscopies in the UK.
Lancet.
2000;
355
1211-1214
10
Rex D K, Cutler C S, Lemmel G T, Rahmani E Y, Clark D W, Helper D J, Lehman G A, Mark D G.
Colonscopic Miss Rates of Adenomas Determined by Back-to-Back Colonoscopies.
Gastroenterology.
1997;
112
24-28
11
Rex D K, Imperiale T F, Portish V.
Patients willing to try colonoscopy without sedation: associated clinical factors and results of a randomized controlled trial.
Gastrointest Endosc.
1999;
49
554-559
12
Rex D K.
Colonoscopy: a review of ist yield for cancers and adenomas by indication.
Am J Gastroenterol.
1995;
90
353-365
13
Schmiegel W, Adler G, Frühmorgen P, Fölsch U, Graeven U, Layer P, Petrasch S, Porschen R, Pox Chr, Sauerbruch T, Schmoll H-J, Zeitz M.
Kolorektales Karzinom: Prävention und Früherkennung in der asymptomatischen Bevölkerung - Vorsorge bei Risikopatienten - Endoskopische Diagnostik, Therapie und Nachsorge von Polypen und Karzinomen.
Z Gastroenterol.
2000;
38
49-75
14
Sonnenberg A, Delcò F, Bauerfeind P.
Is Virtual Colonoscopy a Cost-Effective Option to Screen for Colorectal Cancer?.
Am J Gastroenterol.
1999;
94
2268-2274
15 Statistisches Bundesamt .Statistisches Jahrbuch 1998. Metzler-Poeschel, Stuttgart 1998
16
Winawer S J, Zauber A G, O'Brien M J, Ho M N, Gottlieb L, Sternberg S S, Waye J D, Bond J, Shapiro M, Stewart E T, Panish J, Ackroyd F, Kurtz R C, Shike M,. and National Polyp Study Workgroup .
Randomized comparison of surveillance intervals after colonoscopic removal of diagnosed adenomatous polyps.
NEJM.
1993;
328
901-906
17
Winawer S J, Zauber A G, Ho M N, O'Brien M J, Gottlieb L S, Sternberg S S, Waye J D, Shapiro M, Bond J H, Panish J F, Ackroyd F, Shike M, Kurtz R C, Hornsby-Lewis L, Gerdes H, Stewart E T,. and National Polyp Study Workgroup .
Prevention of colorectal cancer by colonoscopic polypectomy.
NEJM.
1993;
329
1977-1981
18
Winawer S J, Stewart E T, Zauber A G. et al .
A comparison of colonoscopy and double contrast barium enema for surveillance after polypectomy.
NEJM.
2000;
342
1766-1772
Prof. Dr. med. G. Lux
Chefarzt Gastroenterologie und Allgemeine Innere Medizin
Städtisches Klinikum Solingen
Gotenstraße 1
42653 Solingen