Original scientific paper
https://doi.org/10.20471/acc.2024.63.03-04.09
Endoscopic Rectal Ultrasound in Rectal Adenocarcinoma Staging: Can a Surgeon Rely on Endoscopic Findings Before the Surgery? – Comparison with Postoperative Pathological Diagnosis
Melanija Ražov Radas
orcid.org/0000-0003-4530-4350
; Division of Gastroenterology, Department of Internal Medicine, Zadar General Hospital, Zadar, Croatia
*
Nataša Lisica Šikić
orcid.org/0000-0003-3371-1151
; Department of Pathology, General Hospital Zadar, Croatia
* Corresponding author.
Abstract
Our aim in this study was to demonstrate the usefulness of endoscopic rectal ultrasound
scan (ERUS) in providing information that can help surgeons decide on therapeutic approach
and type of surgical procedure in patients with rectal cancer. We compared ERUS findings with postoperative
pathological data in 41 patients with endoscopic and pathological (PH) diagnosis of rectal cancer.
These patients underwent ERUS examination to determine the extent of the disease and the findings
were subsequently compared with postoperative pathological diagnosis. After ERUS examination, there
were three patients in group T0, five in group T1, 12 in group T2, 17 in group T3, two in group T4, and
two patients had a mucinous metastatic type of cancer. After excluding 15 patients who met the exclusion
criteria, we compared ERUS findings of 26 patients with their pathological diagnosis to determine
the sensitivity and accuracy of ERUS. The total sensitivity of the ERUS in preoperative staging of the
tumor stage T0-T4 was 96%. Accuracy was 89%. This study showed that a surgeon can rely on the findings
of ERUS performed by an experienced endoscopist before deciding of type of surgical procedure for
T0-T2, and even T3 degree of rectal cancer. T3 rectal cancers are in the “gray zone”, so both procedures,
ERUS and nuclear magnetic resonance imaging (NMR), are needed to decide on the final therapeutic
approach. NMR remains the gold standard for staging T4 rectal cancer.
Keywords
ERUS; NMR; PH diagnosis; Colorectal adenocarcinoma; Sensitivity; Surgical procedure
Hrčak ID:
333117
URI
Publication date:
31.12.2024.
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