Is preoperative computerized tomography useful in assessing patients with colorectal carcinoma?
OBJECTIVE
Controversy exists over the appropriate preoperative evaluation of colorectal cancer patients. Most surgeons agree that basic laboratory studies are indicated. Computerized tomography of the abdomen and pelvis has been used in our practice to augment the preoperative evaluation of these patients.


METHODS
One hundred fifty-eight consecutive patients with primary colorectal carcinoma underwent computerized tomography (CT) of the abdomen as part of their preoperative evaluation. Their medical records were retrospectively reviewed.


RESULTS
In 88 patients, 120 findings present on CT were otherwise unknown. Of these, 35 percent were clinically significant in that they allowed the surgeon to alter the proposed operative procedure or added additional technical information for consideration preoperatively. Findings include liver metastasis (26), atrophic kidney (3), and abdominal wall or contiguous organ invasion (11). In addition, two other solid organ carcinomas were detected. In the remaining 70 patients, CT contributed no additional pertinent information about the patient prior to this initial operative procedure.


CONCLUSIONS
CT aids in the preoperative evaluation of individuals with colorectal carcinoma. It provides important clinical information that is useful to the surgeon planning the procedure. Additionally, CT permits the patient and his family to be aware of their overall status and to subsequent treatment options. Computerized tomography eliminates the need for preoperative intravenous pyelogram, improves the preoperative staging for metastatic disease, and provides a baseline for comparison during the postoperative follow-up period should recurrence be suspected or adjuvant therapy be planned.
Kerner
B A
BA
Division of Colon and Rectal Surgery, UMDNJ-Robert Wood Johnson School of Medicine, Muhlenberg Hospital, Plainfield.
Oliver
G C
GC
Eisenstat
T E
TE
Rubin
R J
RJ
Salvati
E P
EP
D000230:Adenocarcinoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D000368:Aged; D001649:Bile Duct Diseases / Q000150:complications / Q000000981:diagnostic imaging; D015179:Colorectal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000473:pathology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014565:Urogenital Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology