Intraoperative ultrasonography: a tool for localizing small colonic polyps.
OBJECTIVE
Small colonic polyps are difficult to palpate and thus difficult to localize during surgery. Preoperative injection of dyes and "on-the-table colonoscopy" are some of the methods used to allow the surgeon to find the polyps. The aim of the present study was to evaluate the value of intraoperative ultrasound as a tool that may allow detection of small colonic polyps during surgery.


RESULTS
The study population consisted of nine consecutive patients referred to surgery for polyps of the large bowel that were not amenable to endoscopic removal. At surgery, the colon was filled with saline and than scanned by linear ultrasound probe. In 8 out of 9 patients, intraoperative ultrasound successfully detected all polyps, even those smaller than 0.5 cm. In one patient with two polyps, one in the right colon was easily localized, but a second flat, 0.4-cm tubular adenoma at the splenic flexure was missed. In three patients, intraoperative ultrasound showed penetration into the muscular coat. These polyps were found on pathology to be invasive cancer.


CONCLUSIONS
Intraoperative ultrasound makes it possible for surgeons to easily localize small nonpalpable polyps of the large bowel. Furthermore, it can determine the aggressive potential of these lesions with great accuracy.
Greif
Franklin
F
Department of Surgery A, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, The Sakler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. fgreif@clalit.org.il
Belenky
Alexander
A
Aranovich
David
D
Yampolski
Igal
I
Hannanel
Nisim
N
D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003111:Colonic Polyps / Q000000981:diagnostic imaging* / Q000601:surgery; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography