ACTA FAC. MED. NAISS. 2006; 23(2):85-89

 Original article

Nenad Joksimovic, Rozalinda Popova, Vladimir Serafimoski

Clinic of Gastroenterohepatology, Faculty of Medicine, Skopje Macedonia

SUMMARY

This study is a prospective clinical investigation that includes 596 patients aged 54 years on average, with symptoms such as perirectal pain, rectal bleeding, and change in bowel habit and tenesmus that had been investigated at the Clinic. Rectal cancer was diagnosed by endoscopy and was pathohistologica lly confirmed in 377 cases.
Demonstration of tumor, extension into perirectal fat and lymph node involment were evaluated. Tumors were successfully imaged by endorectal ultrasound.
According to the endosonographical results, patients were divided into 3 groups: operable, inoperable and control group. All patients from the first group classified endosonographically as operable rectal carcinoma were compared with the definite surgical diagnosis. Endosonographicaly, 55 pts (9 5%) had I degree, 115 pts (19 5%) had II degree. The group classified as inoperable rectal tumors (207 pts) is compared with the operative findings of palliatively operated patients. Due to the complications of the primary process (ileuses), 55 pts were operated and endosonographic
diagnosis was confirmed by the operation findings.
The control group of patients (219 pts) which was endosonographically classified to be without signs of primary and secondary neoplasmatic process in the rectal wall was compared with all the findings obtained by rectoscopy, colonoscopy and their combination with histology. Adenocarcinoma ovarii were found in 45 pts (20 5%), Ovarial cyst in 26 pts. (12%), Myoma uteri in 22 pts. (10%), Adeocarcinoma uteri in 37 pts (17%), Adenocarcinoma prostatae in 41 pts (19%), Adenoma prostate in 19 pts (8 5%), IBD in 19 pts (8 5%), perirectal abscesses in 7 pts (3%), M. Hirschprung's disease in 2 pts and torsion of the sigmoid colon in one patient.
The results suggest that transrectal sonography has an important role in the determination of operability of rectal malignoma, following and predicting degree of infiltration and determining precise borders of intramural infiltration. The utility of blind endosonography (BUS) is evident, the method is non-invasive and there are no contraindications. It permits fast, easy and precise evaluation of the rectal cancer extension as well as the diseases of the adjacent organs.

Key words: transrectal endosonography, rectal tumors