Preoperative Application of Transrectal Ultrasound in Predicting Operative Procedures for Rectal Cancer: A Randomized Controlled Trial_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Xiaodong ¹ , LV Donghao ¹ , CUI Beibei ¹ , SHI Yingyu ² , HE Fan ¹ , LI Li ¹

1. Department of Anal-colorectal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;2. Department of Ultrasonic Diagnosis, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Rectal neoplasm; Surgical procedures; Transrectal ultrasound; Preoperative assessment

DOI：

10.7507/1672-2531.20080231

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To investigate the influence of preoperative assessment by transrectal ultrasound (TRUS) on the development of operative procedures for rectal cancer.
Methods 　A total of 110 patients with pathologically proven rectal cancer and distance between tumor to dentate line ≤10 cm were enrolled and randomized into group A (n=55) and group B (n=55) according to a computer-generated random sequence. Both TRUS staging and Clinical Staging System (CS staging) were performed preoperatively in group A, while only CS staging was conducted in group B. Preoperative TRUS stage, CS stage, and proposed operative procedures were recorded to compare with the postoperative pathological stage and practical operative procedures.
Results 　A total of 99 patients were assessed. They were randomized into group A (n=49) and B (n=50), and there were no significant differences in baseline characteristics between the two groups. The difference in staging accuracy was statistically significant (P=0.000) between group A (91.8%) and group B (48.0%). Statistically significant improvement (P=0.013) in the accuracy of proposing operative procedures for rectal cancer was observed in group A (93.9%) compared with group B (76.0%).
Conclusion 　 TRUS is evidently superior to CS staging in preoperative assessment for rectal cancer, and may remarkably enhance the accuracy of proposing operative procedures. Therefore, TRUS is valuable in preoperative assessment which may help to guide the selection of operative procedures for rectal cancer surgery.

Citation： WANG Xiaodong,LV Donghao,CUI Beibei,SHI Yingyu,HE Fan,LI Li. Preoperative Application of Transrectal Ultrasound in Predicting Operative Procedures for Rectal Cancer: A Randomized Controlled Trial. Chinese Journal of Evidence-Based Medicine, 2008, 08(12): 1043-1046. doi: 10.7507/1672-2531.20080231 Copy

1.	Rafaelsen SR, Sørensen T, Jakobsen A, et al. Transrectal ultrasonography and magnetic resonance imaging in the staging of rectal cancer. Effect of experience. Scand J Gastroenterol, 2008, 43(4): 440-446.
2.	Gan SI, Rajan E, Adler DG, et al. ASGE Standards of Practice Committee,. Role of EUS. Gastrointest Endosc, 2007, 66(3): 425-434.
3.	Tjandra JJ, Kilkenny JW, Buie WD, et al. Practice parameters for the management of rectal cancer (revised). Dis Colon Rectum, 2005, 48(3): 411-423.
4.	Engstrom PF, Arnoletti JP, Benson AB, et al. NCCN practice guidelines in oncology. Rectal Cancer, - v.1.2008. www.nccn.org.
5.	Davila RE, Rajan E, Adler D, et al. ASGE guideline: the role of endoscopy in the diagnosis, staging, and management of colorectal cancer. Gastrointest Endosc, 2005, 61(1): 1-7.
6.	Salerno G, Daniels IR, Fisher SE, et al. A comparison of digital rectal examination versus magnetic resonance imaging in the prediction of circumferential resection margin status in patients. Colorectal Disease, 2005, 7 (Suppl 2): 56.
7.	Shirkhoda A, Madrazo BL. Chief editor. Pelvic Ultrasound. USA: Lippincott Williams and Wilkins, 1993, 173-206.
8.	Greene FL, Page DL, Fleming ID, et al. AJCC cancer staging manual. 6th ed. New York(NY). Springer-Verlag, 2002, 113-124.
9.	Kwok H, Bissett IP, Hill GI. Preoperative staging of rectal cancer. Int J Colorectal Dis, 2000, 15(1): 9-20.
10.	Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT and MR imaging: a meta-analysis. Radiology, 2004, 232: 773-783.
11.	汪晓东, 李立. 结直肠肿瘤多学科协作诊治模式下整体构建理念及基本组织构架. 中国普外基础与临床杂志, 2007, 14(3): 339-334.

1. Rafaelsen SR, Sørensen T, Jakobsen A, et al. Transrectal ultrasonography and magnetic resonance imaging in the staging of rectal cancer. Effect of experience. Scand J Gastroenterol, 2008, 43(4): 440-446.
2. Gan SI, Rajan E, Adler DG, et al. ASGE Standards of Practice Committee,. Role of EUS. Gastrointest Endosc, 2007, 66(3): 425-434.
3. Tjandra JJ, Kilkenny JW, Buie WD, et al. Practice parameters for the management of rectal cancer (revised). Dis Colon Rectum, 2005, 48(3): 411-423.
4. Engstrom PF, Arnoletti JP, Benson AB, et al. NCCN practice guidelines in oncology. Rectal Cancer, - v.1.2008. www.nccn.org.
5. Davila RE, Rajan E, Adler D, et al. ASGE guideline: the role of endoscopy in the diagnosis, staging, and management of colorectal cancer. Gastrointest Endosc, 2005, 61(1): 1-7.
6. Salerno G, Daniels IR, Fisher SE, et al. A comparison of digital rectal examination versus magnetic resonance imaging in the prediction of circumferential resection margin status in patients. Colorectal Disease, 2005, 7 (Suppl 2): 56.
7. Shirkhoda A, Madrazo BL. Chief editor. Pelvic Ultrasound. USA: Lippincott Williams and Wilkins, 1993, 173-206.
8. Greene FL, Page DL, Fleming ID, et al. AJCC cancer staging manual. 6th ed. New York(NY). Springer-Verlag, 2002, 113-124.
9. Kwok H, Bissett IP, Hill GI. Preoperative staging of rectal cancer. Int J Colorectal Dis, 2000, 15(1): 9-20.
10. Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT and MR imaging: a meta-analysis. Radiology, 2004, 232: 773-783.
11. 汪晓东, 李立. 结直肠肿瘤多学科协作诊治模式下整体构建理念及基本组织构架. 中国普外基础与临床杂志, 2007, 14(3): 339-334.

Chinese Journal of Evidence-Based Medicine

Preoperative Application of Transrectal Ultrasound in Predicting Operative Procedures for Rectal Cancer: A Randomized Controlled Trial

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content