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Is endosonography useful to select patients for endoscopic treatment of rectal cancer?
E Tobaruela1, D Arribas, N Mortensen
1Departamento de Cirugía Colorrectal, John Radcliffe Hospital, Oxford, England.
Aim:
in recent years there have been remarkable advances in the treatment of rectal cancer, stimulated by a general tendency towards conservative treatment, and aided by the development of diagnostic tools that allow the surgeon to select the most suitable tumors for treatment. In some cases, conservative local excision by transanal endoscopic microsurgery (TEM) may be appropriate. We analyzed the value of transrectal endosonography for the preoperative staging of rectal cancer previous to TEM.
Methods:
data were collected prospectively from a consecutive series of patients with rectal cancer who underwent TEM between January 1994 and December 1997.
Results:
the accuracy of rectal endosonography in predicting rectal wall invasion was 72.7%. 18.2% of the tumors were overstaged and 9. 1% were understaged.
Conclusion:
transrectal endosonography is a useful technique for the selection of patients for TEM but is amenable to further improvement.