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Arch Surg. 2005 Oct;140(10):932-5.

Localizing colorectal cancer by colonoscopy.

Author information

1
Department of Surgery, University of Vermont College of Medicine, 111 Colchester Avenue, Burlington, VT 05401, USA.

Abstract

HYPOTHESIS:

Colonoscopic localization of colorectal carcinoma is frequently inaccurate and unreliable.

DESIGN:

Consecutive case series.

SETTING:

Tertiary care teaching hospital.

PATIENTS:

Three hundred fourteen consecutive patients undergoing surgical resection for colorectal cancer from January 1, 2000, to December 31, 2003.

INTERVENTION:

Surgical resection for colorectal cancer.

MAIN OUTCOME MEASURE:

Incidence of erroneous site localization.

RESULTS:

Two hundred thirty-six patients had complete endoscopic, pathologic, and operative records. Colonoscopy was inaccurate for tumor localization in 49 cases (21%). In 27 (11%) of these cases, a different procedure was required than initially planned; in an additional 10 cases (4%), the surgical approach required modification. Inaccurate localization was associated with previous colorectal procedures on both univariate analysis (odds ratio, 3.94; 95% confidence interval, 1.50-10.32; P<.005) and multivariate analysis (odds ratio, 4.47; 95% confidence interval, 1.64-12.08; P = .003). Having the colonoscopy performed by a surgeon trended toward protection from error on multivariate analysis (odds ratio, 0.47; 95% confidence interval, 0.20-1.08; P = .07). Age, sex, diverticular disease, endoscopist volume and years of training, and bowel preparation had no significant effect.

CONCLUSIONS:

Colonoscopy has a considerable error rate for localization of colorectal cancer, especially when previous colorectal procedures have been performed. Adjunctive localizing techniques, such as endoscopic tattooing, should be strongly considered.

PMID:
16230540
DOI:
10.1001/archsurg.140.10.932
[Indexed for MEDLINE]

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