Routine preoperative abdominal computed tomography in colon cancer: a utility study.
BACKGROUND
There is no proven utility for preoperative scanning of intraperitoneal colonic cancer with computed tomography (CT). A prospective study was conducted where CT was preoperatively incorporated into the management algorithm to ascertain its role in patient treatment.


METHODS
Thoraco-abdominal CT was performed in both the elective and emergency settings in an unselected group of 73 patients referred to a coloproctology unit established over the last 30 months at the Queen Elizabeth Hospital, Barbados. CT and operative findings were compared to determine the influence that the preoperative CT had on surgical decision making.


RESULTS
Unexpected additional pathology was found in 6.8% of patients. Sensitivity for the detection of visceral metastatic disease was 84.6%. Preoperative CT was deemed to be of clinical value in 24.7% of cases and to definitively alter surgical management in 13.7% of patients. These alterations in management included several types of multivisceral resections, the need for ureteric stenting or reimplantation, the utilization of stomas alone and the avoidance of resection in known metastatic disease.


CONCLUSIONS
Preoperative CT of intraperitoneal colonic cancer adds important technical information to the conduct of the surgery and alters therapy in a selected patient group.
Zbar
A P
AP
School of Clinical Medicine and Research, Queen Elizabeth Hospital University of the West Indies, Martindales Road, St. Michael, Barbados. azbar@uwichill.edu.bb
Rambarat
C
C
Shenoy
R K
RK
D000368:Aged; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011300:Preoperative Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012811:Sigmoid Neoplasms / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed