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'One-stop' rectal bleeding clinics without routine flexible sigmoidoscopy are unsafe

P Toomey1, G Asimakopoulos, A Zbar

  • 1Colorectal Surgery Unit, Hammersmith Hospital, London.

Annals of the Royal College of Surgeons of England
|June 12, 1998
PubMed
Summary

A

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Area of Science:

  • Gastroenterology and Colorectal Surgery

Background:

  • Rectal bleeding investigations often involve extensive procedures for benign conditions like hemorrhoids.
  • Over-investigation strains hospital resources and patient well-being.

Purpose of the Study:

  • To evaluate the efficacy of a 'one-stop' clinic for rectal bleeding management.
  • To determine the necessity of routine flexible sigmoidoscopy in this setting.

Main Methods:

  • A 'one-stop' outpatient clinic was implemented for rectal bleeding assessment.
  • Selective flexible sigmoidoscopy was used based on surgeon's clinical judgment.
  • 344 patients were assessed over a 4-month period.

Main Results:

  • 326 patients (94.8%) did not require flexible sigmoidoscopy.
  • 22 patients had persistent bleeding at follow-up.
  • Three previously undetected colorectal cancers were diagnosed via flexible sigmoidoscopy.

Conclusions:

  • A 'one-stop' clinic can efficiently manage most rectal bleeding cases.
  • Routine flexible sigmoidoscopy is crucial for all patients presenting with rectal bleeding to rule out malignancy.

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