Preoperative virtual endoscopy for advanced colorectal cancerwith stenosis

Abstract

When we are going to perform surgical procedure for an advanced colorectal cancer with intestinal stenosis, it is extremely important for determination of the operative method to know the presence of the lesion located oral side intestine of the stenosis. However, the cases in which a colonoscopy can not go through the stenosis, did not have any useful methods to evaluate oral side intestine of the stenosis.
The authors performed virtual endoscopy (VE) for 5 advanced colorectal cancer cases located from the left colon to the rectum, in which a colonoscopy can not go through the stenosis. We had good visualization in the large intestine from the rectum to the stenosis, and from the cecum to the splenic flexure of the colon. All five cases did not have any polyps or tumors.
However, we could not have good visualization from the stenosis to the splenic flexure of the colon because of lack of intestinal expansion by the air. We could not inhibit intestinal spasm from the stenosis to the splenic flexure of the colon without preanesthetic medication such as buscopan.
Though we have to evalute more numbers of cases in the future, the lesion of the oral side intestin of the stenosis will be evaluate sufficiently by using appropriately preparation and preanesthetic medication. Therefore it is conceivable that VE will be extremely useful procedure for advanced colorectal cancer cases with stenosis.