Kuntz C, Glaser F, Buhr H J, Herfarth C
Chirurgische Universitätsklinik Heidelberg.
Chirurg. 1993 Apr;64(4):290-4.
In this study the value of endorectal ultrasound in diagnosis and therapy of large rectal adenomas is shown. Between January 1988 and August 1992 93 patients with the primary diagnosis of adenoma proven by biopsy were examined by endorectal ultrasound. Sonographical differentiation of adenoma and carcinoma was done by echo-structure. Enlarged lymph nodes can be detected too. In 34 of 91 patients carcinoma was found by endorectal ultrasound and 28 were verified histologically. Sensitivity of endorectal ultrasound in detection of carcinoma in enlarged adenomas is 96%. Only preoperative endorectal ultrasound could give decisive criteria to take a second biopsy, to avoid mucosectomy in case of a malignoma or give the advice for a radical operation according to the tumor stage. Further staging of adenomas and small carcinomas is excellent by endorectal ultrasound and the right indication of local therapy can be confirmed.
本研究展示了直肠内超声在大肠腺瘤诊断及治疗中的价值。1988年1月至1992年8月间,对93例经活检确诊为腺瘤的患者进行了直肠内超声检查。通过回声结构对腺瘤和癌进行超声鉴别。肿大淋巴结也可被检测到。91例患者中,34例经直肠内超声发现癌,28例经组织学证实。直肠内超声对肿大腺瘤中癌的检测敏感性为96%。只有术前直肠内超声能提供决定性标准,以进行二次活检、避免在恶性肿瘤情况下进行黏膜切除术或根据肿瘤分期给出根治性手术建议。直肠内超声对腺瘤和小癌的进一步分期效果极佳,可确认局部治疗的正确指征。