The impact of new technology on surgery for colorectal cancer

Table 1 New technology available for colorectal surgeons

INVESTIGATION

Modern endoscopes

Virtual colonoscopy

Trans-rectal ultrasound

Magnetic resonance imaging

Positron emission tomography

Radioimmunoscintigraphy

INTERVENTION

Colonic stents

Transanal endoscopic microsurgery

Minimally invasive surgery

Radiofrequency ablation

Robotics

OUTCOME

Artificial neural networks

Table 2 Rectal cancer staging by TRUS and MRI[24]

	TRUS (%)	MRI (%)
T stage accuracy	80	85
N stage sensitivity	72	81
N stage specificity	80	66

Table 3 Rectal cancer staging by TRUS, MRI and CT[20]

Accuracy of detection	TRUS (%)	MRI (%)	CT (%)
Depth of invasion	81	81	65
Lymph node metastases	63	63	56

Table 4 Advantages of laparoscopic colectomy compared to open colectomy

Mean	Laparoscopic colectomy	Open colectomy
Narcotic use (days)	2.7	4.8
Ileus (days)	3.9	5.9
Hospital stay (days)	6.5	10.2

Table 5 TEMS excision of benign lesions[68,69]

	Lev-Chelouche	Neary
Number	46	21
Distance from dentate line (cm)	3-18 (mean 7)	5-17 (mean 10)
Size (cm)	1- 7 (mean 2.5)	2-12 (mean 3.9)
Recurrence	4 (9%)	1 (5%)

Table 6 TEMS excision of malignant lesions[68,69]

	Lev-Chelouche	Neary
Number	29	19
Distance from dentate line (cm)	3-15 (mean 8)	4-14 (mean 10)
Size (cm)	2-5 (mean 3.2)	1-6 (mean 3.2)
Recurrence	4 (18%)	0 (0%)

Table 7 TEMS excision of benign and malignant lesions[68,69]

	Lev-Chelouche	Neary
Number	75	40
Mortality	1 (1.3%)	0 (0%)
Morbidity	10 (13%)	8 (20%)
Hospital stay (days)	2-13 (mean 5.5)	1-6 (mean 3.2)

Table 8 Median Survival following treatment for CRC liver metastases

Treatment	Median survival
Supportive care[91]	7-11 mo
IV Fluoruoracil chemotherapy[91]	11-14 mo
Hepatic artery chemotherapy[91]	15-17 mo
Radiofrequency ablation[84]	27 mo