Endosonography of the anal canal and rectum

Endosonography has evolved into an effective tool for the accurate preopera tive assessment of anorectal pathology, from idiopathic anal pain to malign ancy. The published data suggest that endosonography is currently the best method for assessing the structural integrity of the anal sphincter and for staging rectal cancer. The development of new treatment modalities for rec tal cancer, including local excision, preoperative radiotherapy, and total mesorectal excision, has increased the importance of accurate preoperative staging to allow the optimum treatment planning. However, there is little i nformation about the impact of endosonographic findings on clinical decisio n making. Education, training, and quality control in the use of endosonogr aphy also require further work This article aims to evaluate the usefulness and Limitations of this technique in clinical practice.