Intraoperative ultrasound in colorectal surgery.
OBJECTIVE
To assess the accuracy of intraoperative ultrasound (IOUS) as a localizing technique for colorectal resections, and its impact on surgical management.


METHODS
Twenty-five patients (15 men and 10 women; mean age, 74.4 years) with early cancers (p T1), or polyps, not amenable to endoscopic removal were selected. IOUS was used as a sole method of intraoperative localization. Its performance was evaluated through review of preoperative colonoscopy reports, intraoperative findings, histopathology reports, and clinical follow-up.


RESULTS
The lesions were situated in the cecum (n = 5), ascending colon (n = 3), transverse colon (n = 4), descending colon (n = 7), and rectum (n = 6). IOUS technique allowed correct localization in 24 of 25 patients, visualization of the bowel wall, and its penetration by malignant tumors. In rectal lesions, IOUS showed clearly the tumor and its margin, which facilitated performance sphincter-sparing procedure.


CONCLUSIONS
In patients with small polyps and early cancers of colon and rectum, IOUS may be effectively used as a sole method of intraoperative localization and provide additional information that may alter decision making with regard to surgical technique.
Greif
Franklin
F
Department of Surgery A, Rabin Medical Center, Beilinson Hospital, Petach-Tikva, Israel.
Aranovich
David
D
Hananel
Nissim
N
Knizhnik
Mikhail
M
Belenky
Alexander
A
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D000368:Aged; D002432:Cecum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000000981:diagnostic imaging / Q000601:surgery*; D007432:Intraoperative Period; D008297:Male; D011446:Prospective Studies; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional / Q000379:methods*