BackgroundColorectal cancer is a major cause of morbidity and mortality and can arise through the adenoma-carcinoma sequence. Colonoscopy is considered the method of choice for population-wide cancer screening.AimTo assess the characteristics of endoscopically resected polyps in a consecutive series of patients who underwent colonoscopy at a university hospital and compare histopathology findings according to patient age and polyp size.MethodsRetrospective, cross-sectional of 1950 colonoscopy reports from consecutively examined patients. The sample was restricted to reports that mentioned colorectal polyps. A chart review was carried out for collection of demographic data and histopathology results. Data were compared for polyps sized ≤0.5 cm and ≥0.6 cm and then for polyps sized ≤1.0 cm and ≥1.1 cm. Finally, all polyps resected from patients aged 49 years or younger were compared with those resected from patients aged 50 years or older.ResultsA total of 272 colorectal polyps were resected in 224 of the 1950 colonoscopies included in the sample (11.5%). Polyps >1 cm tended to be pedunculated (p=0.000) and were more likely to exhibit an adenomatous component (p=0.001), a villous component (p=0.000), and dysplasia (p=0.003). These findings held true when the size cutoff was set at 0.5 cm. Patients aged 50 years or older were more likely to have sessile polyps (p=0.023) and polyps located in the proximal colon (p=0.009). There were no significant differences between groups in histopathology or presence of dysplasia.ConclusionPolyp size is associated with presence of adenomas, a villous component, and dysplasia, whereas patient age is more frequently associated with sessile polyps in the proximal colon.

Most students interviewed consider that participation in preparatory courses is important to be approved in the residency programs' admission exams and that this participation does not hinder the activities of the internship.

Silva SM, Rosa VF, Almeida RM, Coura MMA, Oliveira PG, Sousa JB. Clinical and manometric evaluation of women with chronic anal fissure before and after internal subcutaneous lateral sphincterotomy. J Coloproctol, 2012;32(2):148-153. ABSTRACT: Objective:To evaluate clinical and manometric parameters of chronic anal fissure females undergoing lateral internal sphincterotomy (LIS). Methods: A total of eight women with chronic anal fissure who underwent LIS were included in this study. The preoperative assessment was performed one week before surgery and included general and anorectal examination, anorectal manometry, and Jorge Wexner questionnaire. The post operative follow up was made every 15 days until complete healing. Jorge Wexner questionnaires and anorectal manometry were repeated at 1 month and 3 months after the surgery. Time to healing, manometric changes and complications were assessed. Results: All patients had preoperative increased anal resting pressure. The resting pressures and anal canal length were significantly decreased 3 months after surgery. Patients' complaints of itching and bleeding were also reduced. Fissures healed in 7 patients and median healing time was 45 days. No complications were observed due to the procedure. One patient had transient incontinence to flatus. Conclusion: Lateral internal sphincterotomy provided clinical improvement and reduced resting pressure of the internal anal sphincter in women with chronic anal fissure.Keywords: anal fissure; anal canal; manometry; wound healing. RESUMO: Objetivo: Avaliar a evolução clínica e manométrica de mulheres com fissura anal crônica submetidas à esfincterotomia lateral interna subcutânea. Métodos: Estudo prospectivo com oito pacientes. A avaliação inicial foi realizada por meio de questionários, exame fí-sico e manometria anorretal na semana anterior ao procedimento cirúrgico. Durante o período pós-operatório, as pacientes foram avaliadas clinicamente a cada 15 dias, até a cicatrização completa. Os questionários e a manometria anorretal foram repetidos 1 mês e 3 meses após a operação. Foi avaliado o tempo para cicatrização da fissura, as alterações manométricas e as complicações decorrentes do procedimento. Resultados: Todas as pacientes apresentavam hipertonia esfincteriana interna no período pré-operatório. Após 3 meses da operação, as pressões de repouso e o comprimento do canal anal funcional diminuíram de modo estatisticamente significante. Houve redução das queixas de prurido e sangramento. A cicatrização completa da fissura ocorreu em sete pacientes. A mediana do tempo de cicatrização foi de 45 dias. Não houve complicações decorrentes do procedimento. Uma paciente apresentou incontinência transitória para flatos. Conclusões: A esfincterotomia lateral interna subcutânea proporcionou melhora clínica e diminuição das pressões de repouso dos esfíncteres anais em mulheres com fissura anal crônica.Palavras-chave: fissura anal; esfíncter anal; manometria; cicatrização.Clinical and manometric evaluation of women with chronic anal fissu...