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Purpose: The role of colonoscopy in the prevention of colorectal cancer has been accepted, not only by the medical community but by the federal government as well. This study sought to document the current role of colonoscopy in the practices of colorectal surgeons., Methods: A survey was mailed to members of The American Society of Colon and Rectal Surgeons detailing the scope of colonoscopy in their practices., Results: Surveys were mailed to 1,800 members of The American Society of Colon and Rectal Surgeons; responses were received from 778 (43.2 percent). The mean age was 48 +/- 10 (range, 27-79) years; the mean number of years in practice was 14 +/- 10 (range, 0.2-48). The majority of respondents (91 percent) were male. Responses were received from 47 U.S. states and 30 foreign countries. Seventy-four respondents (9.5 percent) reported not performing colonoscopy; the most common reason cited was "referring physicians' preference" (45 percent). Seven-hundred four respondents (90.5 percent) reported performing colonoscopy as part of their clinical practice and reported an average of 41 +/- 41 colonoscopies in the last month (range, 0-635) and 457 +/- 486 in the last year (range, 2-7,000). Colonoscopy accounted for 23 +/- 16 percent of responding physicians' clinical time (range, 1-100 percent) and 27 +/- 19 percent of total charges (range, 0-100 percent). Nearly all respondents (97 percent) anticipated maintaining or increasing their volume of colonoscopy in the coming year. Eighty-four percent of respondents reported receiving some or all of their training in colonoscopy during a colon and rectal surgery fellowship. More than one-half of respondents (55 percent) believed that there should be more of an emphasis on colonoscopy on the American Board of Colon and Rectal Surgery board examination, and 81 percent believed that the annual meeting of The American Society of Colon and Rectal Surgeons should include lectures and/or courses covering colonoscopy., Conclusions: Colonoscopy plays a major role in the practices of colorectal surgeons across the world, accounting for approximately one-quarter of clinical time and total charges. Based on the expectation that this trend will continue, The American Society of Colon and Rectal Surgeons needs to aggressively support its members not only in the technical aspects of colonoscopy but also in the practice management issues.

The traditional morbidity and mortality associated with traditional management has stimulated exploration of endoscopic approaches. Success depends on patient selection, the location and etiology of obstruction, patient status, and the capability of the endoscopist. This article discusses techniques of intralumenal dilation and stent placement and results from systematic reviews. [ABSTRACT FROM AUTHOR]

Colonoscopy is the premier method for colonic evaluation and its diagnostic accuracy and therapeutic safety depends on the quality of the colonic cleansing. Bowel cleansing with polyethylene glycol and sodium phosphate provides cleansing with high-quality preparations with an acceptably low morbidity rate and a high degree of patient satisfaction in a cost-effective manner. Modifications have reduced the volume of the polyethylene glycol preparations. Sodium phosphate has been associated with electrolyte and osmolarity imbalances and nephrocalcinosis; therefore, its clinical use has been questioned. Polyethylene glycol may be safer in patients with a history of significant renal, heart, or liver disease. [ABSTRACT FROM AUTHOR]

The article presents the guidelines on bowel preparation before colonoscopy prepared by three leading gastrointestinal societies in the U.S. Dietary regimens should include clear liquids and low-residue foods on the first four days as it has been proven to be a beneficial adjunct to other mechanical cleansing systems. Tap water or sodium phosphate enemas are given on the evening prior to the procedure in conjunction with dietary restrictions or cathartics.

Examines the use of colonoscopy in a follow-up examination of adenomas and colorectal cancer. Features of colonoscopy; Profiles of the subjects in the study; Features of colonoscopic follow-up; Recommendations for follow-up colonoscopy.

Background: A 41-year-old man had left upper quadrant abdominal pain, constipation, and melena. About 6 years previously, he received a single gunshot wound to the abdomen, which required partial gastrectomy and small bowel resection. He subsequently developed bleeding gastric varices for which he underwent a splenectomy 2 years before the current admission. Discussion: A CT scan identified a 6.5 × 2.5 cm left upper quadrant mass. Upper endoscopy was unremarkable, but on colonoscopy, a 3-cm polypoid mass partially obstructed the descending colon. A left hemicolectomy was performed with a primary colonic anastomosis and incidental appendectomy. The mass involved the muscularis of the colon and caused ulceration of the mucosa was ectopic hyperplasic splenic tissue, indicating intramural colonic splenosis. We hypothesize that after the patient's splenectomy, a colonic focus of heterotrophic spleen became hyperplastic and led to a clinically apparent lesion. [ABSTRACT FROM AUTHOR]

The article presents the author's views on the importance of colorectal cancer screening which he expressed during the National Colorectal Cancer Awareness month. As mentioned, colorectal cancer is third most common disease in men and women. Various techniques of colorectal cancer screening that are discussed includes colonoscopy, computed tomography (CT) colonography and Ochsner endoscopy.

An introduction is presented in which the editor discusses various reports published within the issue which include the mortality rates from colorectal cancer, the effectiveness of colonoscopy in screening colorectal cancer, and efforts to expand colorectal screening.

A response by Stephania K. C. Timothy et al to a letter to the editor about their article "Colonoscopy in the Patient Requiring Anticoagulation" in the 2001 issue is presented.

A letter to the editor is presented in response to an article which discussed the importance of colonoscopic surveillance.