title: The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery.
abstract: 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.
authors.affiliation: Department of Surgery, St. Paul's Hospital, 1081 Burrard St, Vancouver, British Columbia, V6Z 1Y6, Canada.
authors.forename: Marisa
authors.initials: M
authors.lastname: Leon-Carlyle
authors.affiliation: Department of Radiology, St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Brown
authors.affiliation: Cancer Surveillance & Outcomes, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Surgical Oncology Network, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Hamm
authors.affiliation: Department of Surgery, St. Paul's Hospital, 1081 Burrard St, Vancouver, British Columbia, V6Z 1Y6, Canada.
authors.forename: P Terry
authors.initials: PT
authors.lastname: Phang
authors.affiliation: Department of Surgery, St. Paul's Hospital, 1081 Burrard St, Vancouver, British Columbia, V6Z 1Y6, Canada.
authors.forename: Manoj J
authors.initials: MJ
authors.lastname: Raval
authors.affiliation: Department of Surgery, St. Paul's Hospital, 1081 Burrard St, Vancouver, British Columbia, V6Z 1Y6, Canada. Electronic address: cbrown@providencehealth.bc.ca.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009367:Neoplasm Staging / Q000379:methods*; D012004:Rectal Neoplasms / Q000175:diagnosis*; D012007:Rectum / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult
keywords: Endorectal ultrasound; Neoplasm staging; Rectal neoplasms; Transanal endoscopic microsurgery