大腸癌早期診断による注腸・内視鏡同日併用法 ―診断能および検査前日食の検討―

注腸・内視鏡同日併用法の大腸早期癌診断における有用性の検討，その診断能向上のための検査前日食改善を目的に，同法を施行した94例の診断能，従来のBrown変法に準じた献立食とレトルト食（サンケンクリン）とのX線画像の質，内視鏡時の残渣の程度，被検者への味のアンケートを分析した。発見大腸腫瘍は癌5例（早期癌2例，進行癌3例），ポリープ26例32病変である。早期癌はともにポリープの形態をとり，注腸，内視鏡とも病変を指摘できた。病変の好発部位である直腸・S状結腸で注腸・内視鏡によるダブルチェックができる。前日食の検討ではレトルト食が従来の献立食と比し，注腸・内視鏡ともに優れた腸内洗浄能を有し，味のアンケートからも劣ることはなかった。大腸癌早期発見の2次スクリーニングとして，レトルト食を前日食とする同法の有用性が示された。

The present study was performed (1) to evaluate the validity of co-examination by sigmoidoscopy and barium enema study for the early diagnosis of colon cancer and (2) to find the most suitable preparation method for the co-examination. The co-examination was performed on 94 patients : those with abdominal symptoms and signs suggestive of colonic diseases : those with positive occult blood test in stool : or those asking for the routine examination of the colon. The examination revealed 5 cases of colon cancer (2 with early cancer and 3 with advanced cancer) and 26 eases (32 lesions) with colon polyp. The high detection rate of colonic neoplasms, especially of minute lesions, along with the high rate of early lesions among cancers suggested the validity of the co-examination method for the early diagnosis of colon cancer. The method was not time-consuming and not demanding for both patients and doctors, but was effective in detecting minute lesions by allowing a doublecheck in the high-risk recto-sigmpid region ; in addition, the upper colon could be examined by X-ray. The comparative studies on the currently popular Preparation method (modified Brown's method) and a new method with retort foods (Sankenclean, Sanwa Kagaku Kenkyusho Co., Ltd) revealed that the latter was significantly more effective in cleaning colon lumen and visualizing fine network pattern of the colonic mucosa. In addition, the patients were more satisfied with the taste of the latter.