The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery

Leon-Carlyle, Marisa; Brown, Jacqueline A.; Hamm, Jeremy; Phang, P. Terry; Raval, Manoj J.; Brown, Carl J

doi:10.1016/j.amjsurg.2015.10.018

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…The good outcomes in the ESD group were also associated with fact that the lesions in this group were staged using magnifying chromoendoscopy, while the lesions in the TEM group were staged by ERUS. ERUS is considered a good method for evaluating early rectal cancer and has been increasingly adopted, 26 but recent studies suggest that it might not be so precise, with accuracy ranging from 36% to 78% 27–30 . On the other hand, accuracy of magnifying chromoendoscopy for predicting depth of invasion of early colorectal cancer is reported to be higher than 80%, 31–36 reaching 96.4% in our experience 37 .…”

Section: Discussionmentioning

confidence: 57%

Long‐term outcomes of endoscopic submucosal dissection and transanal endoscopic microsurgery for the treatment of rectal tumors

Kimura

Kawaguti

Nahas

et al. 2020

J of Gastro and Hepatol

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Background and Aim Endoscopic submucosal dissection and transanal endoscopic microsurgery are good options for the treatment of rectal adenomas and early rectal carcinomas, but whether long‐term outcomes of these procedures are comparable is not known. The aim of this study was to address this question. Methods A retrospective single‐center study evaluating 98 consecutive procedures between June 2008 and December 2017 was performed in a tertiary cancer center. Consecutive patients who had undergone either endoscopic submucosal resection or transanal endoscopic microsurgery for rectal adenomas and early rectal carcinomas were evaluated, and long‐term recurrence and complication rates were compared. Results Both groups were similar regarding sex, age, preoperative surgical risk, and en bloc resection rate (95.7% in the endoscopic and 100% in the surgical group, P = 0.81). Mean follow‐up period was 37.6 months. Lesions resected endoscopically were significantly larger (68.5 mm) than those resected by transanal resection (44.5 mm), P = 0.003. Curative resections occurred in 97.2% of endoscopic resections and 85.2% of the surgical ones (P = 0.04). Comparing resections that fulfilled histologic curative criteria, there were no recurrences in the endoscopic group (out of 69 cases) and two recurrences in the transanal group (8.3% of 24 cases), P = 0.06. Late complications occurred in 12.7% of endoscopic procedures and 25.9% of surgical procedures (P = 0.13). Conclusions In our experience, endoscopic submucosal resection seems to have advantages over transanal endoscopic microsurgery, with similar en bloc resection rate and lower rate of late complications and recurrences. Multicenter randomized controlled trials are needed to support our findings.

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Section: Discussionmentioning

confidence: 57%

Long‐term outcomes of endoscopic submucosal dissection and transanal endoscopic microsurgery for the treatment of rectal tumors

Kimura

Kawaguti

Nahas

et al. 2020

J of Gastro and Hepatol

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“…В Испании был проведен анализ данных, цель которого состояла в том, чтобы не только определить точность и специфичность ТРУЗИ, но и выявить факторы, влияющие на результаты ТРУЗИ, и лидирующим показателем в правильной оценке результатов стал опыт врача, проводящего манипуляцию [20]. Еще одно исследование, завершившееся в 2016 г., говорит о том, что для достижения максимальной точности при проведении ТРУЗИ специалист должен выполнять минимум 30 исследований каждый год [24].…”

Section: -4' 2020unclassified

Semiotics and the role of transrectal ultrasound in rectal cancer staging

Демидова

Абдулатипова

Байчоров

et al. 2020

Onkol. koloproktol.

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Transrectal ultrasound (TRUS) is inexpensive and simple method for examining the rectum and surrounding tissues. In particular it is used to preoperatively assess stage, in patients with rectal cancer. By using TRUS is possible to analyze the neoplasm extent, depth of tumor invasion into the layers of the colon wall, the mesorectal lymph node involvement and the circumferential resection margin. This method is comparable to an expensive magnetic resonance imaging scan, and if done correctly could even exceed it. The correct diagnosis, especially in the early stages of the disease, plays an important role in choosing surgical treatment in future. However, to interpret the results, you must be familiar with the anatomy of the rectum and anal canal, as well as follow the simple rules for the preparation and implementation of TRUS. If you follow all the rules, you can answer the question about the possibility of performing organ-preserving surgery and compliance with cancer radicalism.

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Endorectal ultrasound in the identification of rectal tumors for transanal endoscopic surgery: factors influencing its accuracy

et al. 2017

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Endorectal ultrasound (ERUS) is considered the technique of choice for selecting patients for transanal endoscopic surgery (TEM). The aim of this study was to evaluate the accuracy of ERUS in patients with rectal tumors who later underwent TEM, and to analyze the factors that influence this accuracy. Observational study including prospective data collection of patients with rectal tumors undergoing TEM with curative intent between June 2004 and May 2016. Preoperative staging by EUS (uT) was correlated with the pathology results after TEM (pT). The accuracy of the EUS was evaluated and a series of variables (tumor morphology, height, lesion size, quadrant, definitive pathology, the surgeon assessing the ERUS, and waiting time from the date of the ERUS until surgery) were analyzed as possible predictors of diagnostic accuracy. Six hundred and fifty-one patients underwent TEM, of whom 495 met the inclusion criteria. The overall accuracy of EUS was 78%, sensitivity 83.78%, specificity 20%, PPV 91.3%, and NPV 11%. Forty patients (8.08%) were understaged and 50 (10.9%) were overstaged. In the multivariate analysis, the surgeon's experience emerged as the most important predictor of accuracy (p < 0.001; OR 2.75, 95% CI 1.681-4.512). The EUS was less accurate with larger lesions (p = 0.004; OR 0.219, 95% CI 0.137-0.349) and when the definitive diagnosis was adenocarcinoma (p < 0.001; OR 0.84, 95% CI 0.746-0.946). ERUS accuracy rates are variable and there is a possibility of understaging and overstaging that must be taken into consideration. This accuracy is dependent on the operator's experience as well on lesion size; in addition, it is lower for lesions shown to be cancers in the final pathology report.

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The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery

Cited by 4 publications

References 27 publications

Long‐term outcomes of endoscopic submucosal dissection and transanal endoscopic microsurgery for the treatment of rectal tumors

Long‐term outcomes of endoscopic submucosal dissection and transanal endoscopic microsurgery for the treatment of rectal tumors

Semiotics and the role of transrectal ultrasound in rectal cancer staging

Endorectal ultrasound in the identification of rectal tumors for transanal endoscopic surgery: factors influencing its accuracy

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