The Clinical Study Of Erus Stagine And TEM Resection For Early Rectal Cancer

ObjectiveThis study was performed to evaluate the clinic value of endorectal ultrasonography (ERUS) for preoperative staging of rectal carcinoma and the efficacy of transanal endoscopic microsurgery (TEM).MethodsEight-five cases of patients diagnosed as rectal carcinoma by ERUS underwent TEM. Pathological examination was performed to check the accuracy of preoperative staging by ERUS. And the operational injury, recently complication, long-dated oncology prognosis were observed after TEM.ResultsThe accuracy rate of ERUS was 95.3 and 89.4% to diagnose the rectal carcinoma and to judge the depth of infiltration. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the diagnosis for T1 stage were 89.4, 97.1, 75.0, 90.5 and 81.8%, respectively. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the diagnosis for T2 stage were 94.1, 75.0, 97.1, 81.8 and 90.5%, respectively. The incidence of recently complication of TEM was 8.6%, including 4 temporary urinary retentions, 2 incision splits, 1 haemorrhage within anus, and there was no serious complication and death surrounded operation. During the follow-up period (6-48 months, mean 21.5 months), local recurrences and distant metastases developed in 4 and 1 patients respectively and there was no death. Compared with the T1 stage patients, the local recurrent rate of T2 stage patients after TEM was significantly high (3 versus 1, p<0.05).ConclusionERUS for preoperative staging of rectal carcinoma is good and is applicable for TEM. cases of rectal cancer TEM resection of T1 rectal cancer is so safe and effective that it is worth promoting; Rectal cancer sprognosis with merely TEM resection is still owe satisfaction , based on the T2 of TEM Local treatment mode for rectal cancer remains to be further improved.