Rieger Nicholas, Tjandra Joe, Solomon Michael
University of Adelaide Department of Surgery, The Queen Elizabeth Hospital, Woodville Road, Woodville, SA 5011, South Australia.
ANZ J Surg. 2004 Aug;74(8):671-5. doi: 10.1111/j.1445-1433.2004.02884.x.
Endoanal and endorectal ultrasound have an important role in colorectal surgery. They can be applied in the management of faecal incontinence, rectal tumours and inflammatory perianal conditions. In faecal incontinence, anal ultrasound will confirm the presence or absence of sphincter defects. This will direct any operative intervention such as direct sphincter repair. Ultrasound in rectal cancer allows staging of the tumour by assessing the depth of invasion through the bowel wall and involvement of mesenteric nodes. Such staging might influence the choice of operation and determine which patients might benefit from preoperative chemotherapy and radiotherapy. Ultrasound has a particular role in recurrent and complex anal fistula and perianal sepsis. Preoperative and perioperative planning with accurate delineation of fistula tracts, extensions and sphincter involvement might help prevent recurrence and impaired continence from sphincter damage after surgery. Correct interpretation of ultrasound images requires training and experience so that the results can be properly correlated with the clinical situation.
肛管超声和直肠内超声在结直肠手术中具有重要作用。它们可应用于大便失禁、直肠肿瘤及炎性肛周疾病的治疗。在大便失禁方面，肛管超声可确定是否存在括约肌缺陷，这将指导诸如直接括约肌修复等任何手术干预。直肠癌超声检查可通过评估肿瘤浸润肠壁的深度及肠系膜淋巴结受累情况对肿瘤进行分期。这样的分期可能会影响手术方式的选择，并确定哪些患者可能从术前化疗和放疗中获益。超声在复发性和复杂性肛瘘及肛周脓毒症中具有特殊作用。术前和围手术期通过准确描绘瘘管走行、范围及括约肌受累情况进行规划，可能有助于预防术后复发及因括约肌损伤导致的控便功能受损。正确解读超声图像需要培训和经验，以便使结果能与临床情况恰当关联。
