2023, Vol. 5, Issue 2, Part B

Background: Colonic and extracolonic staging is critical in colorectal cancer patients and can be assessed with Conventional Colonoscopy (CC), which is accepted as the gold standard for evaluating the colon; however, there is data that indicates that colonoscope localization of cancer is frequently imprecise and depends on distances may be misguiding. Computed Tomography Colonography (CTC), on the other hand, has demonstrated the ability to offer excellent preoperative staging of colorectal cancer, particularly in cases of incomplete CC, and allows examination of the whole colon, even in cases of obstructive lesions; It also enables proper staging of extracolonic cancer spread. The purpose of this study was to compare CTC to colonoscopy in the identification of colorectal disorders in patients with colonic symptoms and signs.

Methods: A prospective double blind comparative study was conducted on 50 patients suffering colorectal symptoms and altered bowel habits, bleeding per rectum, abdominal pain, weight loss, unexplained fatigue and loss of appetite. All patients involved in the study were subjected to Preparatory investigations, CT virtual colonoscopy and colonoscopy.

Results: The correlation between clinical presentation, colonoscopy, colonographic findings and histopathological results revealed that among 5 abdominal pain cases (2 cases had diverticulum (no finding) and remaining 3 cases had either mass or polyp (adenomatous polyp (moderate dysplasia)) or no finding (no finding) in histopathology). The sensitivity, specificity, PPV, NPV and accuracy of Colonography vs. Colonoscopy in detection of mass in colon was 100%, 93.75%, 90%, 100% and 96.88% respectively. While for colon ulcer they were 44.44%, 100%, 100%, 76.19% and 72.22% respectively. For detecting colon polyp these parameters showed 75%, 100%, and 100%, 95.45% and 87.50% respectively. Lastly, for diverticulum in colon or any abnormality in colon, the result reached 100%.

Conclusion: Colonic and extra colonic staging is critical in colorectal cancer patients and can be assessed with Conventional Colonoscopy (CC), which is accepted as the gold standard for evaluating the colon; however, there is data that indicates that colonoscope localization of cancer is frequently imprecise. The technique enjoys higher sensitivity than conventional colonoscopy in detecting colorectal carcinoma, abnormalities resulting from an obstructive lesion, segmental identification of colon abnormalities, and tumour staging prior to surgery