Clinical value of CT colonography versus preoperative colonoscopy in the surgical management of occlusive colorectal cancer Journal Article


Authors: Horvat, N.; Raj, A.; Ward, J. M.; Smith, J. J.; Markowitz, A. J.; Gollub, M. J.
Article Title: Clinical value of CT colonography versus preoperative colonoscopy in the surgical management of occlusive colorectal cancer
Abstract: OBJECTIVE. CT colonography (CTC) has been recognized as a complementary approach to evaluating the entire colon after incomplete colonoscopy (IC) in patients with occlusive colorectal cancer (CRC). The objective of this study is to evaluate changes in preoperative surgical planning after CTC is performed for patients with occlusive CRC and IC in an oncologic hospital. MATERIALS AND METHODS. This retrospective study included 65 consecutive patients with occlusive CRC who underwent CTC after IC at our institution from February 2000 to April 2016. CTC examinations and radiology reports were reviewed by an abdominal radiologist. Clinical information was obtained from a review of the electronic medical record. RESULTS. CTC contributed to a change in the initial surgical plan of the surgeon for 14 of 65 patients (21.5%). In these 14 patients, CTC detected fve synchronous proximal colon polyps (35.7%), fve synchronous proximal cancers (35.7%), two imprecise CRC locations (14.3%), one case of proximal colon ischemia (7.1%), and one instance of tumor infltration of the urinary bladder (7.1%). All CTC fndings were confrmed at surgery, and all proximal colon polyps were subsequently confrmed to be advanced adenomas. CONCLUSION. The preoperative CTC fndings optimized the surgical management plan for 21.5% of patients with occlusive CRC and IC. © American Roentgen Ray Society.
Keywords: adult; aged; major clinical study; treatment planning; cancer staging; preoperative evaluation; colorectal cancer; retrospective study; colonoscopy; colon cancer; cystectomy; colon resection; iohexol; appendectomy; proctocolectomy; hemicolectomy; ct; computed tomographic colonography; ct colonography; adenomatous polyp; carbon dioxide; rectum anterior resection; total colon resection; sigmoidectomy; glucagon; colorectal polyp; human; male; female; priority journal; article; macrogol 3350
Journal Title: American Journal of Roentgenology
Volume: 210
Issue: 2
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2018-02-01
Start Page: 333
End Page: 340
Language: English
DOI: 10.2214/ajr.17.18144
PROVIDER: scopus
PUBMED: 29261351
PMCID: PMC7473453
DOI/URL:
Notes: Article -- Export Date: 1 March 2018 -- Source: Scopus
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MSK Authors
  1. Marc J Gollub
    208 Gollub
  2. Arnold J Markowitz
    138 Markowitz
  3. Jesse Joshua Smith
    217 Smith
  4. Natally Horvat
    101 Horvat
  5. Aradhna Raj
    3 Raj
  6. John Martin Ward
    2 Ward