[Role of rectal endoscopic ultrasonography in the pre-therapeutical study of villous tumors].
The staging of rectosigmoid villous adenomas is difficult when based only on clinical or endoscopic findings, even when superficial biopsies are taken. Echoendoscopy (EE) with a 7.5 and 12 MHz transducer heads provides good visualization of these lesions. The role of EE in the staging of villous adenomas presenting as benign lesions was prospectively studied. Among 47 patients who had an echoendoscopic investigation for villous adenoma during a 18 month period, 25 had lesions believed to be benign based on clinical and endoscopic findings. In 23 patients (group I, superficial biopsies showed no malignancy; in 2 patients (group II), with 3 lesions, biopsies were positive for in situ carcinoma. Comparisons were made between echographic images and operative specimens. A complete EE investigation was possible in all cases. In group I, there was one tumor T3N+ that was diagnosed by EE only. Twelve other patients had neoplastic lesions limited to the mucosa or submucosa only, and 10 had benign lesions. The integrity of the muscularis propria was imaged in all cases but EE did not differentiate benign lesions from neoplastic lesions invading the mucosa. In group II, parietal staging was correct in 2 of 3 cases. In addition to clinical examination and endoscopic investigations, EE seems useful in the staging of large or high located villous adenomas as well as for the best therapeutic choice.
Roseau
G
G
Clinique de Turin, Paris.
Palazzo
L
L
Rahme
T
T
Paolaggi
J A
JA
D000236:Adenoma / Q000000981:diagnostic imaging* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D011859:Radiography; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D012811:Sigmoid Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography
Place de l'écho-endoscopie rectale dans l'exploration pré-thérapeutique des tumeurs villeuses.