[Transrectal echography in the assessment of anastomosis and local recurrence after prior resection]

The value of rectal endosonography was investigated in the follow-up of the patients submitted to anterior resection for rectal cancer. Rectal endosonography was performed on 42 patients who had been operated on two months to five years before; all patients were monitored according to a carefully planned follow-up schedule including clinical and instrumental examinations and laboratory tests. Sixteen patients had altered clinical and laboratory data; 26 were completely asymptomatic. In the latter group, no signs of local recurrences were found, while in 4 cases the rectal wall appeared homogeneously thickened and hypoechoic: this pattern was due to postoperative or post-irradiation hyperemic-edematous phenomena. In 14 of 16 symptomatic patients, a mass was detected--in 9 of them inhomogeneous and hypoechoic and developing mainly in the perirectal perianastomotic tissue and in 5 limited to the rectal wall, in the anastomotic area. In the last 2 cases, no lesions were found. Both the manual and the stapler anastomoses were always demonstrated, which exhibited different US patterns. US findings were compared with histologic results or were clinically checked in the subsequent follow-up. To conclude, rectal endosonography proved to be useful in the postoperative follow-up of this kind of patients even though it did not allow the differential diagnosis between fibrosis and local recurrence.