[A novel diagnostic method to study the residual pelvic cavity after Miles abdomino-pelvic resection]

Local pelvic perineal recurrence represents the most frequent site of failure following abdominoperineal resection (APR) for rectal cancer. Patients con be studied at this level by Computerized Tomography (CT) scan, Magnetic Resonance Imaging (MRI), suprapubic or, in women, endovaginal ultrasound (US). CT scan and MRI show sensitivity and specificity in excess, respectively, of 70 and 90%, but the high cost and the invasiveness of CT scan controindicate their frequent use. Suprapubic US has no value in terms of diagnostic accuracy, whereas endovaginal US shows a good specificity, but it is quite refused by the patients since the discomfort of the examination. 34 patients from the Rehabilitation Unit of Colostomy Patients at the University of Rome, "La Sapienza", have been blindly followed by transperineal US. The results have been compared with those obtained by CT scan or MRI. Specimens have been obtained of any suspicious mass by needle biopsy. The diagnostic accuracy of transperineal US has resulted comparable to CT scan and MRI. The authors also describe the morphology and US pattern of the pelvic hollow as demonstrated by transperineal US and the distinctive features of abnormality seen.