P-333 - The place of endorectal ultrasound in the management of rectal lesions

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Rectal Cancer
Imaging, Diagnosis and Staging
Presenter M. Ayad
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors M. Ayad, N. Aksil, K. Boualga, M. Haoui
  • EHS Centre Anti Cancer, Blida/DZ



Endorectal ultrasound (ERUS) is a useful adjunct in the staging of rectal lesions. In early rectal cancer the determination of T stage has a vital role in determining radical or local excision. Our aim was to assess the accuracy of ERUS in identifying lesions isolated to the mucosa/submucosa and thus their suitability for transanal endoscopic microsurgery (TEMs).


Patients undergoing ERUS were identified from a prospectively maintained database at our centre over a 25-month period (January 2010 to December 2013). Colonoscopic, MRI and ERUS findings, along with clinical data were assessed and analysed in relation to choice of surgical procedure and histopathology. Our primary outcome measure was T stage measured on ERUS in correlation to staging of the resected specimen.


Over this time period, 59 patients underwent ERUS. A total of 42 patients not receiving neo-adjuvant therapy were included for whom post-resection histopathology was available. TEMs was performed in 35 and total mesorectal excision in 7. ERUS was accurate in 33 of the 42 patients (78%). Identification of ≤T1 lesions had a sensitivity of 69% and a specificity of 100%.


In our experience, ERUS is valuable in confirming clinical suspicion in addition to other modalities that a lesion is confined to the submucosa and therefore suitable for TEMS; however rectal lesions tend to be overstaged.