Computed tomography in patients with colon cancer (case studies and literature review)

Abstract

The radicalism of planned surgical interventions in patients with colon cancer can be increased due to precision computed tomographic diagnosis. Establishing the x‑ray stage of the disease involves determining the localization of the tumor and the extent of lesion of the intestinal wall, visualization of regional lymph nodes, tumor damage of adjacent organs, distant metastases, peritoneal carcinoma, etc. Computed tomography is considered to be a «golden» standard in the diagnosis of colon cancers, but general surgeons in everyday practice use the diagnostic capabilities of сomputed tomography not in it full capacity. An analysis of the diagnostic methods in 78 patients with colon cancer treated in oncological and general hospitals is presented. The clinical examples show the practical possibilities of computed tomographic diagnosis in the preoperative and postoperative periods in cases of radical and non‑radical surgery for left colon cancer. Based on a review of the scientific literature and the results of our own clinical observations, it was established that computed tomographic scan of the abdominal and chest cavities and colonoscopy is a necessary diagnostic component of the examination of the primary patient to establish the clinical and X‑ray stage of colon cancer according to the Tumor — Nodes — Metastases algorithm. For the surgeon and radiologist, the TNM category helps to unite their efforts in the preoperative diagnosis of colon cancer. Thanks to the precision computed tomographic diagnosis, intraoperative errors can be avoided and the surgical procedures can be made more radical. Dispensary сomputed tomography monitoring of patients with colon cancer (in particular, сomputed tomography colonography) allows timely detection of tumor recurrence, its metastases, and monitoring the quality of the primary surgical procedure.