THE VALUE OF ENDOSCOPIC ULTRASONOGRAPHY IN PREOPERATIVE EVALUATION OFRECTAL-CANCER

Background. In rectal cancer, preoperative evaluation of the depth of cancer invasion and the presence of pararectal lymph node metastasis i s essential to determine appropriate operative procedures, especially in autonomic nerve preserving operations. For this evaluation, endosco pic ultrasonography (EUS) was performed prospectively in the following cases. Methods. During the past 5 years, 70 patients with rectal canc er underwent EUS examination by using 7.5 MHz and 12 MHz-EUS sonoprobe systems. Results. The depth of cancer invasion was accurately predict ed by EUS in 76% of cases (53/70), Seventeen cases were incorrectly es timated, 12 of those underestimated, and 5 overestimated. The evaluati on of pararectal lymph node metastasis was accurate in 44 patients (69 %). The sensitivity rate was 36% and specificity was 90%, Conclusions. EUS is a very useful technique for determining therapeutic procedures for rectal cancer, especially in deciding whether or not sphincter pr eserving and/or autonomic nerve preserving operations should be undert aken.