Correlation between preoperative endoscopic and intraoperative findings in localizing colorectal lesions

Martine Adam Louis, Kalyana C. Nandipati, Rakel Astorga, Anupa Mandava, Carl P. Rousseau, Neil Mandava

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Colonoscopy findings compared with findings at time of surgery have a discrepancy rate of 3-21%. The objective of our study was to investigate this discrepancy and provide potential resolutions. Methods: In this retrospective study, we identified 400 patients who underwent colonoscopy followed by colon resection at our community hospitals in 1999-2006. Discrepancies between colonoscopy and intraoperative findings were noted. Each discrepancy was classified as major if the surgical procedure had to be altered, the lesion was missed, an unnecessary segment was removed, or the incision was extended. A discrepancy was classified as minor if there was no alteration in planned surgery. Results: Of the 400 cases, 160 (40%) were located in the right colon, 13 (3%) were in the transverse colon, 185 (46%) were in the left colon, and 42 (11%) were in the rectum. A total of 48 (12%) discrepancies between colonoscopy and intraoperative findings were identified: 26 (54%) were major and 22 (46%) were minor. Thirteen (27%) were in the proximal colon (3 major and 10 minor discrepancies), 3 (6.3%) were in the transverse colon (all major), 22 (46%) were in the distal colon (17 major and 5 minor), and 10 (21%) were in the rectum (3 major, 7 minor). Major discrepancies were significantly higher in the left colon (17 of the 185 left-sided lesions; 9.1%) than in the right colon (3/160; 1.9%; P = 0.045). Conclusions: In our study, colonoscopy has an error rate of 12% when used to localize tumors; more than half of these patients require significant unanticipated changes in their surgery. The discrepancies are significantly higher in left side of colon.

Original languageEnglish
Pages (from-to)1587-1591
Number of pages5
JournalWorld Journal of Surgery
Volume34
Issue number7
DOIs
StatePublished - Jul 2010
Externally publishedYes

Fingerprint

Colon
Colonoscopy
Transverse Colon
Rectum
Community Hospital
Retrospective Studies
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Correlation between preoperative endoscopic and intraoperative findings in localizing colorectal lesions. / Louis, Martine Adam; Nandipati, Kalyana C.; Astorga, Rakel; Mandava, Anupa; Rousseau, Carl P.; Mandava, Neil.

In: World Journal of Surgery, Vol. 34, No. 7, 07.2010, p. 1587-1591.

Research output: Contribution to journalArticle

Louis, Martine Adam ; Nandipati, Kalyana C. ; Astorga, Rakel ; Mandava, Anupa ; Rousseau, Carl P. ; Mandava, Neil. / Correlation between preoperative endoscopic and intraoperative findings in localizing colorectal lesions. In: World Journal of Surgery. 2010 ; Vol. 34, No. 7. pp. 1587-1591.
@article{39985e87be5b44c4a131f9834027fe42,
title = "Correlation between preoperative endoscopic and intraoperative findings in localizing colorectal lesions",
abstract = "Background: Colonoscopy findings compared with findings at time of surgery have a discrepancy rate of 3-21{\%}. The objective of our study was to investigate this discrepancy and provide potential resolutions. Methods: In this retrospective study, we identified 400 patients who underwent colonoscopy followed by colon resection at our community hospitals in 1999-2006. Discrepancies between colonoscopy and intraoperative findings were noted. Each discrepancy was classified as major if the surgical procedure had to be altered, the lesion was missed, an unnecessary segment was removed, or the incision was extended. A discrepancy was classified as minor if there was no alteration in planned surgery. Results: Of the 400 cases, 160 (40{\%}) were located in the right colon, 13 (3{\%}) were in the transverse colon, 185 (46{\%}) were in the left colon, and 42 (11{\%}) were in the rectum. A total of 48 (12{\%}) discrepancies between colonoscopy and intraoperative findings were identified: 26 (54{\%}) were major and 22 (46{\%}) were minor. Thirteen (27{\%}) were in the proximal colon (3 major and 10 minor discrepancies), 3 (6.3{\%}) were in the transverse colon (all major), 22 (46{\%}) were in the distal colon (17 major and 5 minor), and 10 (21{\%}) were in the rectum (3 major, 7 minor). Major discrepancies were significantly higher in the left colon (17 of the 185 left-sided lesions; 9.1{\%}) than in the right colon (3/160; 1.9{\%}; P = 0.045). Conclusions: In our study, colonoscopy has an error rate of 12{\%} when used to localize tumors; more than half of these patients require significant unanticipated changes in their surgery. The discrepancies are significantly higher in left side of colon.",
author = "Louis, {Martine Adam} and Nandipati, {Kalyana C.} and Rakel Astorga and Anupa Mandava and Rousseau, {Carl P.} and Neil Mandava",
year = "2010",
month = "7",
doi = "10.1007/s00268-009-0358-y",
language = "English",
volume = "34",
pages = "1587--1591",
journal = "World Journal of Surgery",
issn = "0364-2313",
publisher = "Springer New York",
number = "7",

}

TY - JOUR

T1 - Correlation between preoperative endoscopic and intraoperative findings in localizing colorectal lesions

AU - Louis, Martine Adam

AU - Nandipati, Kalyana C.

AU - Astorga, Rakel

AU - Mandava, Anupa

AU - Rousseau, Carl P.

AU - Mandava, Neil

PY - 2010/7

Y1 - 2010/7

N2 - Background: Colonoscopy findings compared with findings at time of surgery have a discrepancy rate of 3-21%. The objective of our study was to investigate this discrepancy and provide potential resolutions. Methods: In this retrospective study, we identified 400 patients who underwent colonoscopy followed by colon resection at our community hospitals in 1999-2006. Discrepancies between colonoscopy and intraoperative findings were noted. Each discrepancy was classified as major if the surgical procedure had to be altered, the lesion was missed, an unnecessary segment was removed, or the incision was extended. A discrepancy was classified as minor if there was no alteration in planned surgery. Results: Of the 400 cases, 160 (40%) were located in the right colon, 13 (3%) were in the transverse colon, 185 (46%) were in the left colon, and 42 (11%) were in the rectum. A total of 48 (12%) discrepancies between colonoscopy and intraoperative findings were identified: 26 (54%) were major and 22 (46%) were minor. Thirteen (27%) were in the proximal colon (3 major and 10 minor discrepancies), 3 (6.3%) were in the transverse colon (all major), 22 (46%) were in the distal colon (17 major and 5 minor), and 10 (21%) were in the rectum (3 major, 7 minor). Major discrepancies were significantly higher in the left colon (17 of the 185 left-sided lesions; 9.1%) than in the right colon (3/160; 1.9%; P = 0.045). Conclusions: In our study, colonoscopy has an error rate of 12% when used to localize tumors; more than half of these patients require significant unanticipated changes in their surgery. The discrepancies are significantly higher in left side of colon.

AB - Background: Colonoscopy findings compared with findings at time of surgery have a discrepancy rate of 3-21%. The objective of our study was to investigate this discrepancy and provide potential resolutions. Methods: In this retrospective study, we identified 400 patients who underwent colonoscopy followed by colon resection at our community hospitals in 1999-2006. Discrepancies between colonoscopy and intraoperative findings were noted. Each discrepancy was classified as major if the surgical procedure had to be altered, the lesion was missed, an unnecessary segment was removed, or the incision was extended. A discrepancy was classified as minor if there was no alteration in planned surgery. Results: Of the 400 cases, 160 (40%) were located in the right colon, 13 (3%) were in the transverse colon, 185 (46%) were in the left colon, and 42 (11%) were in the rectum. A total of 48 (12%) discrepancies between colonoscopy and intraoperative findings were identified: 26 (54%) were major and 22 (46%) were minor. Thirteen (27%) were in the proximal colon (3 major and 10 minor discrepancies), 3 (6.3%) were in the transverse colon (all major), 22 (46%) were in the distal colon (17 major and 5 minor), and 10 (21%) were in the rectum (3 major, 7 minor). Major discrepancies were significantly higher in the left colon (17 of the 185 left-sided lesions; 9.1%) than in the right colon (3/160; 1.9%; P = 0.045). Conclusions: In our study, colonoscopy has an error rate of 12% when used to localize tumors; more than half of these patients require significant unanticipated changes in their surgery. The discrepancies are significantly higher in left side of colon.

UR - http://www.scopus.com/inward/record.url?scp=77955469878&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955469878&partnerID=8YFLogxK

U2 - 10.1007/s00268-009-0358-y

DO - 10.1007/s00268-009-0358-y

M3 - Article

VL - 34

SP - 1587

EP - 1591

JO - World Journal of Surgery

JF - World Journal of Surgery

SN - 0364-2313

IS - 7

ER -