Belmonte MC, García AJ

Language: Spanish
References: 18
Page: 159-163
PDF size: 321.90 Kb.

ABSTRACT

Objective: To present the experience in preoperative staging of rectal cancer in a specialized center using endorectal ultrasound.
Setting: Third level health care hospital. Design: Retrospective, longitudinal, descriptive study.
Patients and methods: We reviewed the endorectal ultrasound reports of all the patients with rectal cancer examined from February 1990 to February 1998 that did not receive preoperative radiotherapy, and who were subjected to local or radical resection surgery, and in which, by histopathology, the penetration degree of the rectal wall (278 patients) and of ganglionar invasion (102 patients) could be determined. Studies were performed by expert colorectal surgeons by means of a Bruel Kjael equipment with an 1850 transductor of 7 to 10 MHz. A comparison was made between the ultrasonographic (uTN) and the histopathologic (pTN) stages, determining the ultrasonographic diagnostic certainty, its overestimation, underestimation, sensitivity, specificity, positive and negative predictive value. Kappa’s test to determine certainty of the study was also used. Results: The degree of rectal wall penetration in 278 patients had a global certainty of 79%, with an overestimation of 13% and underestimation of 8%. In the 102 patients with ganglionar involvement the diagnostic certainty was of 64%, sensitivity of 43%, specificity of 78%, positive predictive value of 54%, and negative predictive value of 69%. Kappa’s test yielded a 0.94 certainty coefficient for rectal wall penetration and of 0.52 for positive lymphatic ganglia.
Conclusion: Endorectal ultrasound, although not a perfect technique to stage rectal cancer, provides reliable information to choose the most adequate treatment for each patient.

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