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[Rectal cancer. Staging with transrectal ultrasonography]
G Haarberg1, O A Vengen, A O Aasen
1Gastroenterologisk avdeling, Kirurgisk klinikk, Ullevål sykehus, Oslo.
Summary
Endoluminal rectal ultrasound and digital examination were used to stage rectal cancer preoperatively. Ultrasound staging showed discrepancies in seven patients, but provided valuable additional information for 12 patients.
Area of Science:
- Colorectal Surgery
- Diagnostic Imaging
- Oncology
Background:
- Accurate preoperative staging of rectal carcinoma is crucial for treatment planning.
- Digital examination is a standard method for rectal cancer assessment.
- Endoluminal rectal ultrasound (ERUS) offers detailed visualization of rectal wall layers and perirectal tissues.
Purpose of the Study:
- To evaluate the accuracy of endoluminal rectal ultrasound compared to digital examination for preoperative staging of rectal carcinoma.
- To assess the concordance between imaging findings and histopathological results.
Main Methods:
- Thirty patients with rectal carcinoma underwent preoperative endoluminal rectal ultrasound and digital examination.
- Results were compared with histopathological findings from resected specimens (n=23).
- Surgical procedures included abdominoperineal rectal amputation, low anterior resection, and local excision.
Main Results:
- Discrepancies between ultrasound staging and histology occurred in seven patients (six overstaged, one understaged).
- Digital assessment resulted in eight overstaged and two understaged tumors.
- Endoluminal rectal ultrasound provided additional relevant information in 12 patients.
Conclusions:
- Endoluminal rectal ultrasound is a valuable tool for preoperative staging of rectal cancer, offering complementary information to digital examination.
- While discrepancies exist, ERUS demonstrates potential for improved accuracy in tumor staging.
- Further research can optimize ERUS protocols for enhanced rectal cancer management.