Usefulness of preoperative CT colonography for colon cancer

Kazuhito Sato; Toshiaki Tanaka; Jiro Sato; Eisuke Shibata; Yuzo Nagai; Koji Murono; Koji Yasuda; Kensuke Otani; Takeshi Nishikawa; Junichiro Tanaka; Tomomichi Kiyomatsu; Keisuke Hata; Kazushige Kawai; Hiroaki Nozawa; Shinsuke Kazama; Hironori Yamaguchi; Soichiro Ishihara; Eiji Sunami; Joji Kitayama; Kuni Ohtomo; Toshiaki Watanabe

doi:10.1016/j.asjsur.2016.04.002

Asian Journal of Surgery (Nov 2017)

Usefulness of preoperative CT colonography for colon cancer

Kazuhito Sato,
Toshiaki Tanaka,
Jiro Sato,
Eisuke Shibata,
Yuzo Nagai,
Koji Murono,
Koji Yasuda,
Kensuke Otani,
Takeshi Nishikawa,
Junichiro Tanaka,
Tomomichi Kiyomatsu,
Keisuke Hata,
Kazushige Kawai,
Hiroaki Nozawa,
Shinsuke Kazama,
Hironori Yamaguchi,
Soichiro Ishihara,
Eiji Sunami,
Joji Kitayama,
Kuni Ohtomo,
Toshiaki Watanabe

Affiliations

Kazuhito Sato: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Toshiaki Tanaka: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Jiro Sato: Department of Radiology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Eisuke Shibata: Department of Radiology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Yuzo Nagai: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Koji Murono: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Koji Yasuda: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Kensuke Otani: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Takeshi Nishikawa: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Junichiro Tanaka: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Tomomichi Kiyomatsu: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Keisuke Hata: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Kazushige Kawai: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Hiroaki Nozawa: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Shinsuke Kazama: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Hironori Yamaguchi: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Soichiro Ishihara: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Eiji Sunami: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Joji Kitayama: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Kuni Ohtomo: Department of Radiology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
Toshiaki Watanabe: Department of Surgical Oncology, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan

DOI: https://doi.org/10.1016/j.asjsur.2016.04.002
Journal volume & issue: Vol. 40, no. 6
pp. 438 – 443

Abstract

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Background: Computed tomographic colonography (CTC) is reported to be feasible for screening of colorectal polyps; however, its efficacy in preoperative workup remains unknown. This study was done to define our CTC methodology and assess CTC's potential for preoperative examination in patients with colon cancer. Methods: A total of 86 colon cancer patients underwent CTC prior to laparoscopic colectomy in our department from February 2014 to November 2015. The location of primary colon cancer determined by CTC was compared with that confirmed during the surgery. CTC was performed just after preoperative colonoscopy; for a small colon cancer, we performed clipping during colonoscopy to enhance CTC detectability. We classified wall deformities and compared them with the pathological T stage. Results: CTC accurately located all 87 primary colon cancers prior to surgery. No patient experienced complications associated with CTC. The deformity classification correlated significantly with the pathological T stage (p < 0.001, Kruskal–Wallis nonparametric tests). CTC provided reconstructed images depicting the feeding artery of the primary colon cancer; feeding artery information obtained by CTC facilitated precise lymph node dissection. Conclusion: CTC appears to be a feasible and useful preoperative examination modality for colon cancer treatment.

Published in Asian Journal of Surgery

ISSN: 1015-9584 (Print)
Publisher: Elsevier
Country of publisher: Hong Kong
LCC subjects: Medicine: Surgery
Website: http://www.journals.elsevier.com/asian-journal-of-surgery/

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