Is endosonography useful to select patients for endoscopic treatment of rectal cancer?

AIM: in recent years there have been remarkable advances in the treatment o f rectal cancer, stimulated by a general tendency towards conservative trea tment, and aided by the development of diagnostic tools that allow the surg eon to select the most suitable tumors for treatment. In some cases, conser vative local excision by transanal endoscopic microsurgery (TEM) may be app ropriate. We analyzed the value of transrectal endosonography for the preop erative staging of rectal cancer previous to TEM. METHODS: data were collected prospectively from a consecutive series of pat ients with rectal cancer who underwent TEM between January 1994 and Decembe r 1997. RESULTS: the accuracy of rectal endosonography in predicting rectal wall in vasion was 72.7%. 18.2% of the tumors were overstaged and 9.1% were underst aged. CONCLUSION: transrectal endosonography is a useful technique for the select ion of patients for TEM but is amenable to further improvement.