TY - JOUR
T1 - A critical appraisal of endorectal ultrasound and transanal endoscopic microsurgery and decision-making in early rectal cancer
AU - Ashraf, S.
AU - Hompes, R.
AU - Slater, A.
AU - Lindsey, I.
AU - Bach, S.
AU - Mortensen, N. J.
AU - Cunningham, C.
PY - 2012/7
Y1 - 2012/7
N2 - Aim Transanal endoscopic microsurgery (TEM) for early rectal cancer (ERC) gives results similar to major surgery in selected cases. Endorectal ultrasound (ERUS) is an important part of the preoperative selection process. This study reports its accuracy and impact for patients entered on the UK TEM database. Method The UK TEM database comprises prospectively collected data on 494 patients. This data set was used to determine the prevalence of ERUS in preoperative staging and its accuracy by comparing preoperative T-stage with definitive pathological staging following TEM. Results ERUS was performed in 165 of 494 patients who underwent TEM for rectal cancer. It inaccurately staged rectal cancer in 44.8% of tumours: 32.7% were understaged and 12.1% were overstaged. There was no significant difference in the depth of TEM excision or R1 rate between the patients who underwent ERUS before TEM and those who did not (P=0.73). Conclusion The data show that ERUS is employed in a minority of patients with rectal cancers undergoing TEM in the UK and its accuracy in this 'Real World' practice is disappointing.
AB - Aim Transanal endoscopic microsurgery (TEM) for early rectal cancer (ERC) gives results similar to major surgery in selected cases. Endorectal ultrasound (ERUS) is an important part of the preoperative selection process. This study reports its accuracy and impact for patients entered on the UK TEM database. Method The UK TEM database comprises prospectively collected data on 494 patients. This data set was used to determine the prevalence of ERUS in preoperative staging and its accuracy by comparing preoperative T-stage with definitive pathological staging following TEM. Results ERUS was performed in 165 of 494 patients who underwent TEM for rectal cancer. It inaccurately staged rectal cancer in 44.8% of tumours: 32.7% were understaged and 12.1% were overstaged. There was no significant difference in the depth of TEM excision or R1 rate between the patients who underwent ERUS before TEM and those who did not (P=0.73). Conclusion The data show that ERUS is employed in a minority of patients with rectal cancers undergoing TEM in the UK and its accuracy in this 'Real World' practice is disappointing.
KW - Early rectal cancers
KW - Endorectal ultrasound
KW - Transanal endoscopic microsurgery
UR - http://www.scopus.com/inward/record.url?scp=84862121490&partnerID=8YFLogxK
U2 - 10.1111/j.1463-1318.2011.02830.x
DO - 10.1111/j.1463-1318.2011.02830.x
M3 - Article
C2 - 21920011
AN - SCOPUS:84862121490
VL - 14
SP - 821
EP - 826
JO - Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
JF - Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
SN - 1462-8910
IS - 7
ER -