The value of endoscopic ultrasonography in preoperative evaluation of rectal cancer.

BACKGROUND

In rectal cancer, preoperative evaluation of the depth of cancer invasion and the presence of pararectal lymph node metastasis is essential to determine appropriate operative procedures, especially in autonomic nerve preserving operations. For this evaluation, endoscopic ultrasonography (EUS) was performed prospectively in the following cases.

METHODS

During the past 5 years, 70 patients with rectal cancer underwent EUS examination by using 7.5MHz and 12MHz-EUS sonoprobe systems.

RESULTS

The depth of cancer invasion was accurately predicted by EUS in 76% of cases (53/70). Seventeen cases were incorrectly estimated, 12 of those underestimated, and 5 overestimated. The evaluation of pararectal lymph node metastasis was accurate in 44 patients (69%). The sensitivity rate was 36% and specificity was 90%.

CONCLUSIONS

EUS is a very useful technique for determining therapeutic procedures for rectal cancer, especially in deciding whether or not sphincter preserving and/or autonomic nerve preserving operations should be undertaken.