Tilney H S, Heriot A G, Trickett J P, Massouh H, Edwards D P, Mellor S G, Gudgeon A M
Department of Colorectal Surgery, Frimley Park Hospital, Frimley, UK.
Colorectal Dis. 2006 May;8(4):338-41. doi: 10.1111/j.1463-1318.2006.00927.x.
Endoanal ultrasound (EAUS) has demonstrated high sensitivity and specificity for the structural imaging of anorectal pathology. This study prospectively assessed the impact of intra-operative EAUS on the surgical management of perianal disease.
EAUS was performed prior to and after examination under anaesthesia (EUA) in a consecutive series of patients with perianal disease. The impact of EAUS on the surgery performed was identified.
Forty-three procedures have been performed in 38 patients (21 male, 17 female; mean age 42.7 years, range 6-76 years) over a three year period. Pathologies encountered were fistula-in-ano (42%), fissure-in-ano (26%), complicated perianal sepsis (16%) and carcinoma (5%). No specific abnormality was identified in 5 symptomatic patients (12%). Four patients with fissures had undergone previous sphincterotomy. In 22 cases (51.2%) the EAUS findings affected the surgical management (extent of muscle above a fistula 9 cases, extent of sphincterotomy 7 cases, site of sepsis identified 2 cases, exclusion of sepsis 2 cases, assessment of cancer resectability 1 case, biopsy of intersphincteric lesion 1 case).
Intra-operative EAUS accurately identifies perianal disease and influences the surgical procedure performed. While not essential, it is a useful adjunct especially in recurrent perianal sepsis, undiagnosed anorectal pain and anal fissure.
腔内超声（EAUS）已被证明对肛肠疾病的结构成像具有高敏感性和特异性。本研究前瞻性评估了术中EAUS对肛周疾病手术治疗的影响。
对一系列连续的肛周疾病患者在麻醉下检查（EUA）前后进行EAUS检查。确定EAUS对所实施手术的影响。
在三年期间，对38例患者（男21例，女17例；平均年龄42.7岁，范围6 - 76岁）进行了43例手术。所遇到的病理情况为肛瘘（42%）、肛裂（26%）、复杂性肛周脓毒症（16%）和癌（5%）。5例有症状的患者（12%）未发现特定异常。4例肛裂患者曾接受过括约肌切开术。在22例（51.2%）中，EAUS检查结果影响了手术治疗（瘘管上方肌肉范围9例，括约肌切开范围7例，确定脓毒症部位2例，排除脓毒症2例，评估癌症可切除性1例，活检括约肌间病变1例）。
术中EAUS能准确识别肛周疾病并影响所实施的手术操作。虽然不是必需的，但它是一种有用的辅助手段，尤其在复发性肛周脓毒症、未确诊的肛肠疼痛和肛裂中。
