Colonoscopy and computerised tomography scan are not sufficient to localise right sided colonic lesions accurately.
Affiliation
Department of Surgery, Beaumont Hospital, Dublin.Issue Date
2009-11-23
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Colonoscopy and computerised tomography scan are not sufficient to localise right sided colonic lesions accurately. 2009: Colorectal DisJournal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and IrelandDOI
10.1111/j.1463-1318.2009.02144.xPubMed ID
19930147Abstract
: Aim: accurate pre-operative localisation of colonic lesions is critical especially in laparoscopic colectomy where tactile localisation is absent particularly in screen-detected tumours. The study aimed to evaluate the accuracy of colonoscopy and double-contrast computerised tomography (CT) to localise lesions treated by right hemicolectomy. Method: a retrospective chart review was performed of patients treated by right hemicolectomy under the colorectal service between July 2003 and October 2006. Pre-operative tumour location determined by CT scan and colonoscopy were compared with the intra-operative and histopathologic findings. Results: of 101 patients, 73 (73%) were for adenoma or cancer, with a final diagnosis of adenocarcinoma in 59 (59%). Pre-operative localisation was inaccurate in 29% of lesions using both CT and colonoscopy. In the transverse colon colonoscopy alone was only 37.5% accurate, increasing to 62.5% when information from the CT scan was added. Conclusion: pre-operative localisation of right-sided colon cancers using colonoscopy and CT scanning is unreliable in at least 29% of cases. Inaccurate localisation of transverse colon tumours risks inadequate lymphadenectomy with an adverse cancer outcome. Pre-operative abdominal CT scan improves accuracy but endoscopic tattoo localisation should be employed routinely especially in patients undergoing laparoscopic resection.Item Type
ArticleISSN
1463-1318ae974a485f413a2113503eed53cd6c53
10.1111/j.1463-1318.2009.02144.x
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