Detry R, Gigot J F, Gérard R
Service de Chirurgie Digestive et d'Anatomie Pathologique, Cliniques Universitaires Saint-Luc, UCL, Bruxelles Belgique.
Gastroenterol Clin Biol. 1988 Nov;12(11):810-3.
From November 1986 to December 1987, endorectal ultrasound (EUS) has been performed 57 times in a total of 54 patients. In the cancers of the low and mid rectum (n = 34), the extent of the tumoral infiltration was accurately assessed by preoperative EUS in 88% of cases. Sensitivity of tumor spread beyond the rectal wall was 0.96. Classification of lymph nodes was more hazardous. The muscular layer was intact in 5 villous adenomas. The diagnosis was difficult in the case of a huge and massively secreting tumour. In the follow-up of the patients after rectal resection(n = 11) or local excision (n = 3) for cancer, EUS allowed an accurate analysis of the suture line in 12 cases. Three submucosal recurrences were detected. The follow-up showed no recurrence in the other cases with a tumor-free suture line pattern. The literature confirms that EUS is a non invasive, efficient and inexpensive method in the preoperative staging of non stenotic rectal tumors. The problem of accuracy of lymph node staging has not been resolved. The technique shows some promise in detecting local recurrences.
1986年11月至1987年12月,共对54例患者进行了57次直肠内超声检查(EUS)。在低位和中位直肠癌患者(n = 34)中,术前EUS对肿瘤浸润范围的准确评估率达88%。肿瘤侵犯直肠壁外的敏感度为0.96。淋巴结分类则更具难度。5例绒毛状腺瘤的肌层完整。对于巨大且大量分泌的肿瘤,诊断较为困难。在直肠癌患者行直肠切除(n = 11)或局部切除(n = 3)后的随访中,EUS对12例患者的缝合线进行了准确分析。检测到3例黏膜下复发。随访显示,其他缝合线无肿瘤的病例未出现复发。文献证实,EUS在非狭窄性直肠肿瘤的术前分期中是一种无创、有效且廉价的方法。淋巴结分期的准确性问题尚未解决。该技术在检测局部复发方面显示出一定前景。