Pre-operative computed tomography of carcinoma of the rectum

Abstract

Fifty-two patients with carcinoma of the rectum underwent computed tomography (CT) in the immediate preoperative period. CT was used in order to assess extrarectal tumor spread. The resected specimen was staged by the pathologist who subdivided spread in continuity beyond the bowel wall into slight, moderate or extensive. In 21 out of 23 patients with no or slight extrarectal local spread CT showed normal perirectal fat. Extrarectal spread was demonstrated by CT in 8 of the 9 patients found to have extensive local spread. This was seen to be circumferential in the only 2 patients with inoperable tumors. CT identified discrete nodal enlargement in 7 of the 18 patients with histologically involved lymph nodes. CT may help the less experienced surgeon, especially when he is not confident of his findings at digital examination. CT allows assessment of high rectal tumors which cannot be examined digitally. It may play a role where a tumor with extensive local spread is clinically suspected and confirmation is needed before preoperative radiotherapy is given.