title: The contributions of virtual colonoscopy to laparoscopic colorectal surgery.
abstract: OBJECTIVE
  Operative tumor or polypectomy site localization and synchronous colonic lesions are challenging problems especially in laparoscopic surgery. We designed this prospective study to determine the contributions of virtual colonoscopy to laparoscopic colorectal surgery.
  
  
  METHODS
  Virtual colonoscopy was performed in 40 consecutive patients who had undergone laparoscopic resection for colorectal neoplasm. Preoperative findings of optical colonoscopy and virtual colonoscopy, operative data, tumor localizations and histopathologic findings were assessed.
  
  
  RESULTS
  Accuracy rates for virtual colonoscopy and optical colonoscopy were 97.5% and 55%, respectively (P<0.05). Polypectomy site was localized with virtual colonoscopy in five patients. There were nine partially obstructing tumors that did not allow optical endoscope passage. Four of six synchronous tumors (one tumor and three polyps) couldn't be shown with optical colonoscopy because of distal obstructing tumor. Histopathologic investigations revealed adenocarcinoma (n=34), adenoma demonstrating low-grade dysplasia (n=3) and high-grade dysplasia (n=2) and neuroendocrine carcinoma (n=1). Mean tumor size was 4 (1.5-10) cm. Mean proximal and distal surgical margins were 15 (5-36) cm and 7.3 (0.8-27) cm, respectively. Overall patient preference was 87.5% for virtual colonoscopy.
  
  
  CONCLUSIONS
  Correct localization of colorectal neoplasm or polypectomy site is mandatory before laparoscopic colorectal surgery. Virtual colonoscopy is a safe, minimally invasive three-dimensional imaging method and may be an alternative localization technique.
authors.affiliation: Department of Surgery, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey. bilgibaca@hotmail.com
authors.forename: Bilgi
authors.initials: B
authors.lastname: Baca
authors.forename: Doğan
authors.initials: D
authors.lastname: Selçuk
authors.forename: Ilknur Erenler
authors.initials: IE
authors.lastname: Kilic
authors.forename: Sibel
authors.initials: S
authors.lastname: Erdamar
authors.forename: Ziya
authors.initials: Z
authors.lastname: Salihoğlu
authors.forename: Ismail
authors.initials: I
authors.lastname: Hamzaoğlu
authors.forename: Tayfun
authors.initials: T
authors.lastname: Karahasanoğlu
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D023881:Colonography, Computed Tomographic; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*