[Endorectal echography as a guide to the surgical approach to tumors of the median-lower rectum].

There is no difference in the late results of destructive and conservative surgery in the treatment of rectal cancers, provided that preoperative staging is correct. Thirty-two patients with medium-low rectal cancer underwent endorectal US to evaluate local cancer spread; the aim was allow the correct surgical treatment to be carried out. US findings were compared with pathology: US diagnostic reliability was 93.75%, with 1 case of understaging (T2 as T1) and 1 case of overstaging (T2 as T3). Endorectal US, thanks to its high reliability, is therefore of basic importance because it allows the best local therapy to be chosen and risk margin to be determined. Moreover, US correctly evaluates the degree of parietal infiltration and local spread, thus helping preserve a more or less wide resection margin during destructive surgery. Therefore, endorectal US stands out as a basic research method in the correct preoperative staging of medium-low rectal cancers according to T, thus allowing a rational surgical approach and helping avoid not only unnecessary destructive surgery but also local recurrences.