Abstract
581 Background: Full preoperative colonic evaluation is recommended to exclude synchronous lesions. In patients with occlusive colorectal cancers, preoperative colonoscopy may not be possible because of narrowing of the lumen. After colonic stent placement, colonoscopy to the proximal part of the obstruction is feasible. However, a complete preoperative colonoscopy was not possible in some cases. The aim of our study was to evaluate the efficacy of preoperative CT and PET-CT for detection of synchronous neoplasms compared with colonoscopy in colorectal cancer obstruction patients who underwent colonic stent. Methods: A retrospective chart review of 205 patients who performed endoscopic colon stent placement for acute malignant colorectal obstruction between January 2010 and October 2015. To find synchronous cancer and other precancerous lesion, we reviewed CT, PET-CT finding and colonoscopic image. The results of CT and PET-CT were compared with the finding of the colonoscopy, which was remains the most reliable method for the detection of synchronous neoplasm. Results: Of the 205 patients with colonic stent placement, 115 patients underwent CT, PET-CT and preoperative colonoscopy passing through the colonic stent. On preoperative colonoscopy, 3 of 115 patients (2.7%) had synchronous cancers and 11 of 115 patients (9.6%) had large polyps (tubulovillous adenoma with high grade dysplasia). On CT and PET-CT, all synchronous lesions were detected. But among the eleven polyps, nine polyps had not been seen at CT and PET-CT. Conclusions: Our study indicates that CT and PET-CT were feasible and useful method of evaluating the entire colon to exclude synchronous colonic lesions in patients with acute colon obstruction after an effective stent placement. But colonoscopy should be performed shortly to find out precancerous lesion especially adenoma with high grade dysplasia.
Published Version
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