Effects of endorectal ultrasonography in the surgical management of rectal adenomas and carcinomas.
BACKGROUND
Accurate preoperative staging of rectal lesions can help select patients for treatment options. This prospective study examines the effects of endorectal ultrasonography (ERUS) in the management of resectable adenomas and adenocarcinomas.


METHODS
Between November 1995 and August 1998, 34 patients had resection of their rectal lesions (28 adenocarcinomas, 6 adenomas). Preoperative clinical stage and surgical and adjuvant therapy plans were specified before ERUS staging; then comparisons were made to postoperative pathologic stage and actual treatment.


RESULTS
ERUS helped select 7 of 11 patients (64%) for preoperative chemoradiation therapy. Treatments of adenocarcinomas were altered by ERUS to local excision (LOC) in 4 of 9 patients (45%) planned for low anterior resection (LAR), and 2 of 10 patients (20%) planned for abdominoperineal resection (APR). ERUS helped spare 2 patients with adenoma from APR.


CONCLUSIONS
ERUS is a useful modality in the surgical management of patients with rectal adenomas and carcinomas.
Lee
P
P
Colon and Rectal Clinic, Portland, Oregon 97205, USA.
Oyama
K
K
Homer
L
L
Sullivan
E
E
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D000236:Adenoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D019160:Endosonography; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods; D010347:Patient Care Planning; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000000981:diagnostic imaging