Intraoperative ultrasonography: a tool for localizing small colonic polyps

Area of Science:

• Gastroenterology
• Surgical Oncology
• Medical Imaging

Background:

• Small colonic polyps are challenging to palpate and localize during surgical procedures.
• Current methods like dye injection and intraoperative colonoscopy have limitations for polyp detection.
• Accurate localization is crucial for effective surgical resection of colonic polyps.

Purpose of the Study:

• To evaluate the efficacy of intraoperative ultrasound in detecting small colonic polyps.
• To determine if ultrasound can assist surgeons in localizing nonpalpable polyps during surgery.
• To assess the capability of intraoperative ultrasound in identifying invasive cancer in polyps.

Main Methods:

• A prospective study involving nine patients undergoing surgery for unresectable colonic polyps.
• The colon was distended with saline and scanned using a linear ultrasound probe during surgery.
• Ultrasound findings were correlated with surgical findings and subsequent pathological examination.

Main Results:

• Intraoperative ultrasound successfully detected polyps in 8 out of 9 patients, including those smaller than 0.5 cm.
• One flat 0.4-cm tubular adenoma at the splenic flexure was missed in one patient.
• Ultrasound accurately identified invasion into the muscularis propria in three polyps, which were confirmed as invasive cancer pathologically.

Conclusions:

• Intraoperative ultrasound is a valuable tool for the precise localization of small, nonpalpable colonic polyps.
• The technique demonstrates high accuracy in assessing the depth of invasion and aggressive potential of colonic lesions.
• Ultrasound can enhance surgical decision-making and improve outcomes for patients with colonic polyps.