Endoanal and endorectal ultrasound: applications in colorectal surgery

Abstract

Endoanal and endorectal ultrasound have an important role in colorectal surgery. They can be applied in the management of faecal incontinence, rectal tumours and inflammatory perianal conditions. In faecal incontinence, anal ultrasound will confirm the presence or absence of sphincter defects. This will direct any operative intervention such as direct sphincter repair. Ultrasound in rectal cancer allows staging of the tumour by assessing the depth of invasion through the bowel wall and involvement of mesenteric nodes. Such staging might influence the choice of operation and determine which patients might benefit from preoperative chemotherapy and radiotherapy. Ultrasound has a particular role in recurrent and complex anal fistula and perianal sepsis. Preoperative and perioperative planning with accurate delineation of fistula tracts, extensions and sphincter involvement might help prevent recurrence and impaired continence from sphincter damage after surgery. Correct interpretation of ultrasound images requires training and experience so that the results can be properly correlated with the clinical situation.

The Role of Endorectal Ultrasound and Magnetic Resonance Imaging in the Management of Early Rectal Lesions in a Tertiary Center

“…19,30 Similar to ERUS, use of MRI also presents difficulty in differentiating between tumor infiltration and desmoplastic reactions (a reactive alteration, occurring around tumors, resulting in fibrous extensions that might or might not contain tumor cells). 31,32 At our institution, endorectal coils are not routinely used for MRI, but improved accuracy has been suggested with their use, by allowing accurate differentiation of all the layers of the rectum.…”

Developing a new electromyography-based algorithm to diagnose the etiology of fecal incontinence

“…Maximal squeeze pressure (MSP) was defined as the maximal pressure during voluntary sphincter contraction in the same localization where MBP was previously measured. Transanal ultrasonography was performed using a Logiq 7 ultrasound machine (General Electric, Great Britain), with a 10–16 MHz probe [14]. …”

Preoperative Staging of Rectal Cancer: Role of Endorectal Ultrasound

“…and gives indications to radiotherapists to plan irradiation fields (depth and length of infiltration). Furthermore it is capable of examining the anal sphincters for defects as well as tumor infiltration, allowing the surgeon to decide whether a sphincter-saving resection is safe or feasible (45). The accuracy of ERUS has been assessed in many studies and the main evidence emerged has been that T-staging accuracy varies relative to tumor stage.…”