Background The aim of this study was to evaluate the impact of low-volume vs. standard-volume bowel preparation on participation in screening colonoscopy, bowel preparation quality, and lesion detection rates. Methods This was a multicenter, randomized, health services study within the population-based primary colonoscopy screening program in Poland. Individuals aged 55 – 62 years were randomized in a 1:1 ratio to bowel preparation with a low-volume (0.3 L sodium picosulfate with magnesium citrate) or standard-volume (4 L polyethylene glycol) regimen and then invited to participate in screening colonoscopy. The primary outcome measure was the rate of participation in screening colonoscopy. Compliance with the assigned bowel preparation, bowel preparation quality, and lesion detection rates were also evaluated. Results A total of 13 621 individuals were randomized and 13 497 were analyzed (6752 in the low-volume group and 6745 in the standard-volume group). The participation rate (16.6 % vs. 15.5 %; P = 0.08) and compliance rate (93.3 % vs. 94.1 %; P = 0.39) did not differ significantly between the groups. In the low-volume group, fewer participants had adequate bowel preparation compared with the standard-volume group (whole colon 79.0 % vs. 86.4 %, P < 0.001; proximal colon 80.1 % vs. 87.3 %, P < 0.001). Detection rates of advanced adenoma (AADR) and advanced serrated polyps (ASPDR) were lower in the low-volume group than in the standard-volume group (AADR in the proximal colon 2.6 % vs. 4.3 %, P = 0.02; ASPDR in the whole colon 2.0 % vs. 3.3 %, P = 0.04; ASPDR in the proximal colon 1.0 % vs. 1.9 %, P = 0.048). Conclusion When compared with a standard-volume bowel preparation with polyethylene glycol, low-volume bowel preparation with sodium picosulfate/magnesium citrate did not improve participation rate or lesion detection rates, and negatively affected bowel preparation quality.

IntroductionGastric cancer is one of the most common malignant neoplasms in the world. Currently it constitutes the third cause of death among all malignancies. New endoscopic techniques have a potential to improve treatment results due to more frequent detection of early gastric cancer.AimTo summarize our experience in diagnosis and treatment of early gastric cancer patients.Material and methodsWe analyzed the results of endoscopic examination, histopathological findings and treatment methods in 16 patients who were diagnosed with early gastric cancer in the Endoscopy Unit of the Oncology Center in Bydgoszcz between 2014 and 2016.ResultsBetween 2014 and 2016 sixteen patients, 12 (75.0%) male and 4 (25.0%) female, were diagnosed with early gastric cancer. The average age of patients was 65.5 years. Surgery qualification concerned mainly G2 and G3 adenocarcinomas. In 12 (75.0%) patients total gastrectomy was performed, and 1 patient underwent wedge resection of the prepyloric part of the stomach. In 3 cases endoscopic submucosal dissection (ESD) was performed. Histopathological examination of both biopsy and postoperative material indicated 8 (50.0%) cases of intestinal-type adenocarcinoma, 7 (43.75%) cases of diffuse-type adenocarcinoma and 1 (6.25%) case of mixed-type adenocarcinoma. During the follow-up after treatment, none of the patients was diagnosed with local or distant recurrence.ConclusionsAccurate examination technique allows for detection of early gastric cancer. Selected cases of early gastric cancer may be treated with advanced endoscopic techniques.

Introduction: Colonoscopy and PET / CT are among the major diagnostic tests for colorectal cancer. The sensitivity, specificity, and accuracy of these studies are still being assessed differently. Objective: The aim of the study was to compare the sensitivity, specificity and accuracy of colonoscopy and PET / CT in the diagnosis of colorectal cancer. Material and methods: The medical records of 125 patients with colonoscopy and PET / CT in the years 2014-2015 were analyzed retrospectively. The research was done at the Professor Franciszek Łukaszczyk Oncology Center in Bydgoszcz. Based on the macroscopic description of colonoscopy, the results were divided into two groups: with and without probability of cancer. The average SUV value in PET / CT for colorectal cancer was calculated and without this diagnosis. The average value of SUV 14 and higher was considered probable, while 11 or less had no probability of cancer. Standardized mathematical formulas were used to evaluate the sensitivity, specificity and accuracy. Results: More than half of the patients - 78 (62.4%) were males. The majority of patients -42 (36.6%) were aged 65-74. The majority (106) (68.8%) were diagnosed as polyps and 24 (15.6%) as tumor-like lesions. Polyps were placed in the rectum -32 (30.2%), in the sigmoid colon - 26 (24.5%) and 15 (13.2%) in the ascending colon. Tumors were located in the rectum - 11 (45.8%) and 4 (16.7%) in the recto-sigmoid junction. 38 (24.6%) adenocarcinomas and 67 (43.5%) adenomas were diagnosed. The detection rate of RJG was 32% in colonoscopy and PET / CT. The sensitivity of the colonoscopy was 80%, the specificity - 68.4% and the accuracy - 71.4%. The sensitivity, specificity and accuracy of PET / CT were 65%, 75%, 4% and 72.7%, respectively. Conclusions: Colonoscopy has a higher sensitivity in colorectal cancer diagnosis, but specificity and accuracy are higher in PET / CT. Keywords: colorectal cancer, colonoscopy, PET / CT, sensitivity, specificity, accuracy

Schwannoma is a common soft tissue tumour, but it appears to be very rare in the gastrointestinal tract. Benign schwannoma develops extremely rarely in the mesocolon, with only 2 patients reported in the literature. A 75-year-old woman was admitted to our Department of Oncological Surgery with an abdominal mass, which was discovered incidentally during abdominal ultrasound examination. Positron emission tomography/ computed tomography imaging with the use of 18F-fluorodeoxyglucose (FDG PET/CT) showed an abnormal mass in the upper right abdomen with the presence of diffuse FDG uptake. A laparotomy revealed an encapsulated, non-invasive mesocolon tumour in the hepatic flexure region. Definitive diagnosis was confirmed by the histopathological examination of the postoperative preparation. Immunohistochemical staining confirmed benign mesocolon schwannoma. Previous cases indicate that schwannomas in the mesocolon are benign tumours. Our patient had a good prognosis even after enucleation treatment. Although schwannomas are very rare and generally asymptomatic, the differential diagnosis of schwannomas and gastrointestinal stromal tumours is important for practical purposes.

B Ba ac ck kg gr ro ou un nd d: : Colorectal cancer is an important health problem in Poland as well as around the whole world. Radical or palliative treatment often requires making an artificial stoma in many patients. A Ai im m o of f t th he e s st tu ud dy y: : To assess physical rehabilitation and psycho-sexual problems of patients with rectum cancer and stoma. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : 50 patients with stoma who had undergone surgery because of rectal cancer participated in this survey. The survey was performed in the Oncology Centre in Bydgoszcz in 2008. The questionnaire contains questions related to socio-demographic information, self-assessment about used physical rehabilitation and psychosexual feelings. R Re es su ul lt ts s: : 28%, 34% and 28% of patients know the goals of rehabilitation before surgery and during the early and late period after surgery, respectively. Information regarding psychological and sexual help was given to 12 (24%) and 3 (6%) patients, respectively. Basic physical activity before surgery was declared by 30 patients (60%), physical activity was not changed in 22 (44%) after surgery. Changes in intimate life after colostomy under cessation of sexual relations were observed in 18 patients (36%). As many as 46 patients (92%) did not use any assistance from a psychologist or sexologist. C Co on nc cl lu us si io on ns s: : In the peri-operative period physical rehabilitation as part of treatment of patients with colorectal cancer and stoma was not sufficient. Only a few patients used psycho-sexual rehabilitation; it was the most neglected element of rehabilitative treatment. Patients with the most severe disease feel resigned to their fate, fear of death as well as happiness that they can be alive.K Ke ey y w wo or rd ds s: : rectal cancer, stoma, rehabilitation, psycho-sexual problems.