Use of Colonoscopy in identifying Malignant and Non-malignant Anorectal Conditions prior to Surgery
Author(s): Nitin Kumar Patel*, Saranshi Shrivastava and Parth Patel
Purpose of study: Colonoscopy is a commonly used diagnostic and therapeutic procedure for colon disorders. It is preferably performed on adults with lower GI symptoms such as abdominal pain, chronic diarrhoea, blood per rectum, constipation, prolapse from the rectum, changes in bowel habits, iron deficiency or anaemia. Colonoscopy is the gold standard diagnostic for inflammatory bowel disease (IBD) and Colon neoplasms; however, early diagnosis of these conditions is still limited. Hence, in this study, we study the role of colonoscopy screening in patients undergoing surgical treatment of anorectal conditions to identify missed lesions in routine perirectal and proctoscopy examination and confirm the findings of ultrasonography anorectal symptoms. Methods: We have included colonoscopies of 96 patients who underwent various surgical procedures at R. D. Gardi Medical College and associated hospitals from December 2019 to April 2021. Data on age, gender, medical symptoms, comorbidities and family history were collected, and a colonoscopy was done prior to surgery. Results: Colonoscopic examinations resulted in 80 abnormal findings, of which 12 were malignant. Twelve anorectal conditions that would have been missed otherwise were diagnosed among the 80 abnormal findings, including ulcerative colitis, haemorrhoids, tubercular colitis, fissure in ano and Carcinoma colon and carcinoma rectum. The most common symptoms that were significantly associated with abnormal findings were burning sensation or pain in the anal region, blood in stools, weight loss, diarrhoea and family history. Conclusion: Colonoscopy is emerging as a community screening tool to identify malignancy in a very early stage. Our results emphasize the need to perform a simple out/ inpatient colonoscopy procedure before undertaking any anorectal surgery that may facilitate the early detection of colon malignancies.