Added value of CT colonography after a positive conventional colonoscopy: Impact on treatment strategy(307 views visite) Mainenti PP, Romano M, Imbriaco M, Camera L, Pace L, D'Antonio D, Bucci L, Galloro G, Salvatore M
IBB CNR, Naples, Italy Dept. Biomorphological Funct. Sci., University Federico II, Via Pansini, 5, 80131 Naples, Italy Department of Surgery and Endoscopy, University Federico II, Via Pansini, 5, 80131 Naples, Italy Corso Vittorio Emanuele, 670, 80122 Naples, Italy
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Tate, J. J. T., Rawlinson, J., Royle, G. T., Preoperative or postoperative colonic examination for synchronous lesions in colorectal cancer (1988) Br J Surg, 7, pp. 1016-1018
Thorson, A. G., Christiansen, M. A., Davis, S. J., The role of colonoscopy in the assessment of patients with colorectal cancer (1986) Dis Colon Rectum, 29, pp. 306-311
Gluecker, T. M., Fletcher, J. G., CT colonography (virtual colonoscopy) for the detection of colorectal polyps and neoplasms: Current status and future developments (2002) Eur J Cancer, 38, pp. 2070-2078
Fenlon, H. M., McAneny, D. B., Nunes, D. P., Occlusive colon carcinoma: Virtual colonoscopy in the preoperative evaluation of the proximal colon (1999) Radiology, 210, pp. 423-428
Gerstenberger, P. D., Plumeri, P., Malpractice claims in gastrointestinal endoscopy: An analysis of an insurance industry database (1993) Gastrointest Endosc, 39, pp. 132-138
Marshal, J. B., Barthel, J. S., The frequency of total colonoscopy and terminal ileal intubation in the 1990 s (1993) Gatrointest Endosc, 39, pp. 518-520
Waye, J. D., Bashkoff, E., Total colonoscopy: Is it always possible? (1991) Gastrointest Endosc, 37, pp. 152-154
Rodney, W. M., Dabov, G., Cronin, C., Evolving colonoscopy skills in a rural family practice: The first 293 cases (1993) Fam Pract Res J, 13, pp. 43-52
Rex, D. K., Bond, J. H., Feld, A. D., Medical-legal risks of incident cancers after clearing colonoscopy (2001) Am J Gastroenterol, 96, pp. 952-957
Ness, R. M., Rex, D. K., Imperiale, T., Translating clinical research to community-based practice: Lessons from colorectal cancer screening and diagnosis (1999) Endoscopy, 31, pp. 170-173
Harvey, C. J., Amin, Z., Hare, C. M., Helical CT pneumocolon to assess colonic tumors: Radiologic-pathologic correlation (1998) AJR, 170, pp. 1439-1443
Morrin, M. M., Farrell, R. J., Raptopoulos, V., Role of virtual computed tomographic colonography in patients with colorectal cancers and obstructing colorectal lesions (2000) Dis Colon Rectum, 43, pp. 303-311
Haseman, J. H., Lenimel, G. T., Rahmani, E. Y., Rex, D. K., Failure of colonoscopy to detect colorectal cancer: Evaluation of 47 cases in 20 hospitals (1991) Gastrointest Endosc, 37, pp. 125-127
Added value of CT colonography after a positive conventional colonoscopy: Impact on treatment strategy
Background: Conventional colonoscopy (CC) requires an experienced operator to avoid technical or interpretative errors, and an endoscopic error rate of 14% for tumor localization has been reported. We evaluated the impact of computed tomographic colonography (CTC) on surgical treatment strategy in patients with CC reported as having colorectal neoplasm. Methods: Fifty-three patients testing positive for colorectal neoplasm on CC underwent CTC: 32 patients had CC in our hospital (group A) and 21 had CC in area hospitals (group B). All CTC procedures were performed with a multidetector CT system. The results of CTC and CC were compared with that of surgery. The preoperative surgical planning evaluated on the basis of CC and CTC was compared with the actual surgical approach, and the percentage of patients in whom CTC modified the treatment strategy suggested by CC was calculated. Results: CTC changed the treatment strategy in four of 53 patients (7.5%) in whom CC showed technical or interpretative errors. Group analysis showed that CTC did not influence the surgical management in any patient in group A but did affect treatment strategy in four of 21 patients (19%) in group B. The effect of CTC on treatment strategy between groups was statistically significant (p < 0.05). CTC identified five adenomas and three adenocarcinomas localized proximally to an impassable stenosis. Conclusion: CTC can be used to reevaluate the findings of a positive CC and can indicate a more correct therapeutic approach in patients with colorectal neoplasms who are candidates for surgery.
Added value of CT colonography after a positive conventional colonoscopy: Impact on treatment strategy
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