THE PREOPERATIVE STAGING OF RECTAL-CARCINOMA

Objectives: To determine the accuracy of digital rectal examination, e ndorectal ultrasound and computed tomography in an attempt to improve objectivity of preoperative staging of rectal carcinoma. Design: Prosp ective study of 35 patients with rectal cancer from May 1990 to Januar y 1992. Setting: Teaching hospital in Czecho-Slovakia. Subjects: Patie nts presenting to the general surgical unit with rectal carcinoma. Mai n outcome measures: To determine the most accurate preoperative stagin g modality in terms of the degree of local tumour size, tumour invasio n, mobility and accessibility, the presence of involved mesorectal lym ph nodes for selection of the most appropriate management. Results: Co mparison of three diagnostic procedures in preoperative staging of rec tal adenocarcinoma of 35 patients showed that the most accurate method is endorectal ultrasound. Out of 19 patients the preoperative diagnos is was fully confirmed in 15 patients - 78.94%. Accuracy of computed t omography was 72.72% (8 of 11) and of digital rectal examination was 6 3.15% (12 of 19). Conclusions: Digital rectal examination, computed to mography and endorectal ultrasound are the current modalities of asses sing preperatively the stage of rectal carcinoma. From our study endor ectal sonography is the most accurate method in the preoperative stagi ng of rectal carcinoma.