American journal of surgery · 2015
The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery.
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Leon-Carlyle Marisa, Brown Jacqueline A, Hamm Jeremy, Phang P Terry, Raval Manoj J, Brown Carl J
Аннотация
BACKGROUND: Endorectal ultrasound (ERUS) is used to preoperatively assess locoregional stage in patients with rectal neoplasms. This study evaluates the accuracy of ERUS in determining the T stage of rectal neoplasms treated by transanal endoscopic microsurgery (TEM).
METHODS: All patients in the St Paul's Hospital TEM database were evaluated and excluded if they had been treated with neoadjuvant therapy. ERUS results were compared with gold-standard postoperative histopathology reports. Tumor height from anal verge was measured by ERUS and endoscopic techniques.
RESULTS: Fifty-three patients were eligible to participate in the study. A Friedman test demonstrated significant difference in the T stage between ERUS and the histopathology reports (P < .001). The tumor height measured by ERUS is significantly higher than the height measured by endoscopy (P < .05).
CONCLUSIONS: This study confirms that ERUS often overstages rectal neoplasms and suggests that ERUS findings should not preclude TEM in clinically appropriate patients.
METHODS: All patients in the St Paul's Hospital TEM database were evaluated and excluded if they had been treated with neoadjuvant therapy. ERUS results were compared with gold-standard postoperative histopathology reports. Tumor height from anal verge was measured by ERUS and endoscopic techniques.
RESULTS: Fifty-three patients were eligible to participate in the study. A Friedman test demonstrated significant difference in the T stage between ERUS and the histopathology reports (P < .001). The tumor height measured by ERUS is significantly higher than the height measured by endoscopy (P < .05).
CONCLUSIONS: This study confirms that ERUS often overstages rectal neoplasms and suggests that ERUS findings should not preclude TEM in clinically appropriate patients.