par Nyst, Jean-François 
;Denis, Patricia ;Van Geel, J.F.;Alle, Jean-Louis ;Deprez, Carine ;Deltenre, Michel Arthur
Référence Acta endoscopica, 24, 1, page (59-62)
Publication Publié, 1994-01
;Denis, Patricia ;Van Geel, J.F.;Alle, Jean-Louis ;Deprez, Carine ;Deltenre, Michel Arthur Référence Acta endoscopica, 24, 1, page (59-62)
Publication Publié, 1994-01
Article révisé par les pairs
| Résumé : | Preoperative staging of rectal carcinoma by endoscopy, conventional radiology or CT scan is usually very disappointing for both depth of the infiltration into the rectal wall or perirectal tissues and in detection of parietal lymph nodes. In the same way, local recurrences are diagnosed too late by the same methods and chances for curative reintervention are very low. The aim of this study is to evaluate the clinical value of EUS in early diagnosis of local recurrence. For 40 months, 136 EUS were performed [with the Olympus GF-UM2, GF-UM3 or CF-UM3 echoendoscope (7.5 MHz or 12 MHz)] in 81 patients as follow-up after surgical resection of a previous rectal carcinoma. We performed EUS examination of the rectal suture and 10 cm above and below, every 6 months. In the post-operative follow-up group of 81 patients 23 cases of recurrence were suspected by EUS,- 14 underwent second look surgery, with confirmation of the diagnosis in all of them (only 5 of 14 were positive at endoscopic biopsy), - 7 patients did not undergo for second look surgery - 1 had no evidence of recurrence 20 months after EUS. - 1 patient had 2 positive EUS but negative biopsies, the patient wanted like to have a third EUS before surgery. 58 patients demonstrated no recurrence at EUS (no false negative). Various abnormalities can be observed in the suture area but only hypoechoic nodule -usually in the submucosa or muscularis propria - is of diagnostic value. Our results show that EUS is one of the best procedures currently available for assessing parietal involvement and staging of rectal carcinoma. EUS might be able to guide therapeutical options. EUS is a sensitive method to early diagnose local recurrence and lets the surgeon the opportunity for a second surgical - maybe curative - resection. © 1994 Springer-Verlag. |
