Mini‐probe ultrasonography for the staging of colon cancer: a systematic review and meta‐analysis

Gall, Tamara; Markar, Sheraz R.; Jackson, Dan; Haji, Amyn; Faiz, O

doi:10.1111/codi.12445

Cited by 40 publications

(27 citation statements)

References 26 publications

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“…stage, differentiation, location, margins of resection and dysplasia where applicable. Preoperative staging of the tumours has been performed with magnetic resonance imaging (MRI) of the rectum and endorectal ultrasound (EUS), which are proven to have high diagnostic accuracy when combined (21)(22)(23)(24). We have an established follow-up protocol for these patients with an intensive 5-year surveillance consisting of 6 monthly endoscopy, carcinoembryonic antigen (CEA), MRI scan and computed tomography (CT) scan for 3 years, which is altered to annual surveillance in years 4 and 5 (Table I).…”

Section: Methodsmentioning

confidence: 99%

KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer

Sideris

Moorhead

Díaz‐Cano

et al. 2016

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Abstract. Background The method of local excision, that has recently, gained wider acceptance, in early rectal cancer, is transanal endoscopic microsurgery (TEMS). TEMS generally offers advantages in operative access and oncological clearance over transanal resection (TAR), but recently a number of similar logic techniques with various rectal ports for endoscopic excision of rectal tumours has been invented. Those methods are collectively named transanal minimal-invasive surgery (TAMIS) and for oncological purposes they share the same features of local excision as TEMS (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).TEMS is a minimally invasive technique that was introduced by Buess in the early 1980's (2). Through the new rectoscope with 3D binocular optic and the endoscopic instruments, it offers better access to proximal lesions with lower margin positivity and fragmentation and magnification of the operative field (2, 15). TEMS is a safe procedure that offers low complication rates and peri-operative morbidity (10.7%) (4). There have been multiple studies to suggest that TEMS is the operation of choice for rectal adenomas (1), retrorectal and submucosal rectal lesions (5). Furthermore, TEMS offers the advantage of not damaging the anorectal function (7).TEMS is indicated as a curative treatment for malignant neoplasms that are histologically confirmed as pT1 sm1 carcinomas, whereas T1 sm2-3 and T2 lesions are still under question (8). A number of studies have shown that TEMS can have comparable results with radical surgery (1,8,12,16) for rectal cancer.There has been concern about oncologic outcomes following TEMS (17). Some studies support that there is potentially a higher risk of local recurrence rate with TEMS (8,10,18). Efforts have been made to classify risk with morphological and histological criteria with better patients' selection (1, 6-9); however, the risk stratification remains 5315

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Section: Methodsmentioning

confidence: 99%

KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer

Sideris

Moorhead

Díaz‐Cano

et al. 2016

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“…In fact, with the current techniques aiming at endoscopic resection of colonic lesions, such as mucosectomy and submucosa dissection, several authors defend the need to assess the lesion by EUS prior to these therapies (1,2,(6)(7)(8) and compare the results obtained by different ultrasonographic frequencies (6,8). Moreover, colon wall thickness is sometimes a limiting factor in applying endoscopic resection techniques and may influence the management approach (9).…”

Section: Introductionmentioning

confidence: 99%

Echoendoscopic characterization of the human colon

et al. 2015

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Purpose: To characterize colon and rectum walls, pericolic and perirectal spaces, using endoscopic ultrasonography miniprobes.Methods: Sixty individuals (50% males), aged 18-80, were included. Using 12 and 20 MHz endoscopic ultrasonography miniprobes, all different colon segments (ascending, transverse, descending, sigmoid) and rectum were evaluated according to the number and thickness of the different layers in intestinal wall, to the presence and (largest) diameter of vessels in the submucosa and of peri-intestinal nodes.Results: The 20 MHz miniprobe identified a higher number of layers than the 12 MHz miniprobe, with medians of 7 and 5 respectively (p < 0.001). The rectal wall (p = 0.001), its muscularis propria (p < 0.001) and mucosa (p = 0.01) were significantly thicker than the different segments of the colon, which had no significant differences between them. Patients aged 41-60 presented thicker colonic wall and muscularis propria in descending (p = 0.001 and p = 0.004) and rectum (p=0.01 and p=0.01). Submucosal vessels were identified in 30% of individuals in descending and rectum, and in 12% in ascending. Adenopathies were observed in 9% of the colon segments and 5% in rectum.Conclusions: A higher frequency enabled the identification of a higher number of layers. Rectal wall is thicker than the one from all the segments of the colon and there are no differences between these, namely in the ascending colon. Moreover, periintestinal adenopathies were rarely identified but present in asymptomatic individuals. All together, these results describe for the first time features which are relevant during staging and therapeutic management of colonic lesions.

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“…High frequency catheter mini-probes have been developed for upper and lower GI examination in conjunction with standard endoscopy, employing frequencies ranging from below 20 MHz to greater than 30 MHz (28). Primary indications include use for local 'T' staging and establishing the feasibility of endoscopic mucosal resection (EMR) (29,30).…”

Section: Qualitative Aspectsmentioning

confidence: 99%

Ultrasound capsule endoscopy: sounding out the future

Cox¹,

Stewart²,

Lay³

et al. 2017

Ann. Transl. Med.

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Video capsule endoscopy (VCE) has been of immense benefit in the diagnosis and management of gastrointestinal (GI) disorders since its introduction in 2001. However, it suffers from a number of well recognized deficiencies. Amongst these is the limited capability of white light imaging, which is restricted to analysis of the mucosal surface. Current capsule endoscopes are dependent on visual manifestation of disease and limited in regards to transmural imaging and detection of deeper pathology. Ultrasound capsule endoscopy (USCE) has the potential to overcome surface only imaging and provide transmural scans of the GI tract. The integration of high frequency microultrasound (µUS) into capsule endoscopy would allow high resolution transmural images and provide a means of both qualitative and quantitative assessment of the bowel wall. Quantitative ultrasound (QUS) can provide data in an objective and measurable manner, potentially reducing lengthy interpretation times by incorporation into an automated diagnostic process.The research described here is focused on the development of USCE and other complementary diagnostic and therapeutic modalities. Presently investigations have entered a preclinical phase with laboratory investigations running concurrently.

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Mini‐probe ultrasonography for the staging of colon cancer: a systematic review and meta‐analysis

Abstract: Mini-probe EUS is highly effective for assigning clinical stage in colon cancer and in identifying patients who may be suitable for nonsurgical treatment including neoadjuvant chemotherapy or endoscopic resection.

Cited by 40 publications

References 26 publications

KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer

KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer

Echoendoscopic characterization of the human colon

Ultrasound capsule endoscopy: sounding out the future

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