التعريف والنظرة العامة
A proctoscopy is an endoscopic medical procedure used to examine the anal canal, rectum, and the sigmoid colon. It plays a key role in the treatment and management of rectal and anal diseases and is considered one of the simplest and most commonly performed diagnostic procedures, along with proctosigmoidoscopy and lower intestinal endoscopy.
The procedure is performed using a proctoscope, a rigid and hollow metal or plastic scope around 13 cm in length, which makes it a bit longer than the anoscope (~10 cm in length) and the rectoscope (~25 cm in length). The tube has an attached small light source that provides illumination while an attached camera sends visual images to a computer monitor for the doctor or technician to examine.
من يجب أن يخضع للنتائج المتوقعة
Proctoscopy can be recommended if the following conditions are suspected:
- Anal fissures
- Rectal polyps
- Benign rectal tumour
- Rectal or anal cancer
- Inflammatory diseases affecting the anal region
- Amoebiasis or intestinal parasitic infection
A proctoscopy is expected to provide additional information and visual evidence to confirm a diagnosis. Based on studies, the procedure can detect up to 70% of all abnormalities affecting the entire 5 feet length of the large intestine. Thus, many experts believe that the procedure should be a physician’s first step when confronted with a diagnostic problem involving the large intestine. Compared to a roentgenogram, which requires fasting and purgation, a proctoscopy is not only simpler but its results are also easier to interpret.
If necessary and when possible, proctoscopy can also be used to perform certain treatments or diagnostic measures, such as:
- Rectal biopsy, or the removal of a piece of tissue from an abnormal growth or polyp for further analysis
- Polypectomy, or the removal of a polyp
- Sclerotherapy, for the treatment of haemorrhoids
- Rubber-band ligature, for the treatment of haemorrhoids
Depending on the results of proctoscopy, additional procedures may be recommended to rule out other medical conditions and make a diagnosis.
كيف يتم إجراء العملية؟
A proctoscopy is performed using a thin hollow tube called a proctoscope, which is available in non-disposable metal types as well as disposable plastic types. One of the most commonly used is Kelly’s rectal speculum, a non-disposable type named after Howard Atwood Kelly, an American gynaecologist.
To perform proctoscopy, the doctor or technician first examines the anal region for any abnormalities while the patient is lying down on his left side with his knees pulled up towards his chest. The doctor then lubricates the proctoscope before slowly inserting it into the anal canal and gradually pushing it into the rectum. If necessary, the doctor will inject air through the proctoscope to improve visuals during the procedure, which typically lasts for around 15 minutes or even less.
No preparation is required before a proctoscopy, except for an enema to clean the bowel, which allows the doctor to see more clearly during the proctoscopy. If the patient is taking blood-thinning medications, he is advised to consult his physician about the proctoscopy to determine whether he needs to stop taking the said drugs.
The procedure can be performed with or without sedatives, depending on the patient’s pain tolerance level and the doctor’s recommendations. If sedatives are used, the patient will have to stay at the hospital until the effects of the sedatives wear off. If no sedatives were used, the patient is allowed to go home immediately after the procedure.
It is normal for patients to feel mild to moderate discomfort while the procedure is being performed, especially as the proctoscope is inserted further into the rectal canal. The use of more modern fibre optic proctoscopes, however, significantly reduces the discomfort that accompanies a proctoscopy.
المخاطر والمضاعفات المحتملة
A proctoscopy is a safe and simple procedure with minimal risks including allergic reactions to the sedatives used, if any, and the possibility of rectal bleeding. The risk of bleeding is higher when the patient already experienced rectal bleeding prior to the test and when a خزعة was performed. However, bleeding is usually minimal and resolves without treatment.
Sorensen HT., Ejlersen E., et al. “Overall use of proctoscopy in general practice and possible relation to the stage of rectal cancer.” Oxford Journals. 9(2): 145-148. http://fampra.oxfordjournals.org/content/9/2/145.abstract
Schroder S. “Value of proctoscopy in diagnosis of amebias.” The American Journal of Medicine. 1948 Aug; 5(2): 319. http://www.amjmed.com/article/0002-9343(48)90080-1/abstract
What is Proctoscopy: Overview, Benefits, and Expected Results
What is Proctoscopy?
Proctoscopy (also referred to as rectoscopy) is a medical procedure that is used to examine the rectum and anus. It is performed using a proctoscope, which is a lighted instrument that is inserted into the rectum for direct viewing of the affected area. The procedure is usually done as an outpatient procedure and takes about 20 to 30 minutes to complete.
Purpose of Proctoscopy
This procedure is primarily used to identify any problems with the rectum and anal canal. It can help to diagnose cancers, tumors, ulcerative colitis, internal hemorrhoids, anal fissures, and other conditions that affect the lower section of the large intestine. It is also sometimes used to remove polyps or foreign bodies that have become lodged in the rectum or anus.
Preparation for Proctoscopy
On the day of the procedure, you should make sure not to eat or drink anything for several hours in advance. You should also make sure to wear comfortable, loose-fitting clothing for the procedure. The doctor performing the proctoscopy will usually need to insert a lubricated proctoscope into your anus and rectum, so it’s best to relax as much as possible while this is happening.
Benefits of Proctoscopy
There are several benefits associated with this procedure. For instance, it can provide your doctor with a better view of the rectum, as the proctoscope has a lighted tip that makes it easier to see any potential issues that were previously undetectable. It can also be used to remove polyps or foreign bodies that have become lodged in the rectum or anus. Additionally, it can help your doctor diagnose or rule out certain conditions, such as cancer or ulcerative colitis.
Risks of Proctoscopy
Although serious complicatons are rare, some of the possible side effects of a proctoscopy procedure include anal bleeding, discomfort, infection, and pain at the site of insertion. In some cases, the procedure may also cause severe rectal bleeding or rectal damage.
Expected Results of Proctoscopy
The results of a proctoscopy procedure will depend on the specific indication for the procedure. For example, if the doctor is looking for polyps or foreign bodies, then they may be able to remove them on the same day. If they are looking for signs of cancer, then they may need to take tissue samples during the procedure that will need to be sent to a lab for further analysis. In some cases, the results of a proctoscopy procedure may not be available for several days or weeks.
Proctoscopy is a relatively safe procedure that can provide your doctor with a better view of the rectum and anal canal. It can be used to diagnose or rule out certain conditions, as well as remove polyps or foreign bodies that have become lodged in the rectal area. Although serious complications are rare, there are some risks associated with the procedure, such as infection, anal bleeding, or rectal damage. Keep in mind that the results of the procedure may not be available immediately, so it’s important to stay in touch with your doctor for any follow-up tests or results.