Accuracy of endoscopic ultrasound in the preoperative staging and the guidance of transanal endoscopic microsurgery for rectal cancer
10.3760/cma.j.issn.1671-0274.2015.05.021
- VernacularTitle:超声内镜对直肠癌术前分期的准确性及对经肛门内镜显微手术的指导意义
- Author:
Xuchao CAI
1
;
Guangwei LIU
;
Yun LU
;
Wanbin YIN
Author Information
1. 266000,青岛大学附属医院黄岛院区普通外科
- Keywords:
Endoscopic ultrasound;
Preoperative stage;
Rectal neoplasms,early;
Transanal endoscopic microsurgery
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(5):487-490
- CountryChina
- Language:Chinese
-
Abstract:
[Abstact] Objective To explore the accuracy of endoscopic ultrasound (EUS) in preoperative staging of rectal cancer and to guide the treatment of transanal endoscopic microsurgery (TEM) in early rectal cancer. Methods Clinical data of 80 patients with rectal cancer receiving EUS examination for preoperative staging in our department between June and December 2012 were retrospectively analyzed. Consistence comparison of EUS preoperative staging and pathological staging was performed to identify the accuracy of EUS preoperative staging. All the patients underwent operation within 1 week after EUS examination. According to preoperative staging, early rectal cancer (Tis or T1N0M0) patients with lesions less 20 cm to anus underwent TEM. Results The overall accuracy of EUS for preoperative T stage was 68.8%(55/80), and for T1, T2, T3, T4 was 91.3%(73/80), 83.8%(68/80), 77.5%(62/80), 85.0%(67/80), which had a good consistence with postoperative pathological T staging (Kappa=0.562). The overall accuracy of EUS for preoperative N stage was 52.7%(39/74), and for N0, N1, N2 stage was 64.9%(48/74), 55.4%(41/74), 85.1%(63/74), which had a poor consistence with postoperative pathological N staging (Kappa=0.235). Six patients underwent TEM successfully, with mean operation time 99(65 to 123) min, without intraoperative and postoperative complication, and were discharged 2-3 days after operation. Enteroscope showed good recovery 1 month later. Pathology confirmed that all the lesions were early rectal cancer. During postoperative follow-up of 14.8 (11 to 19) months, there was no local recurrence and distant metastasis. Conclusion Preoperative EUS has a good accuracy with pathologic T stage, and can guide TEM in early rectal cancer.
