Controversy -Endoscopic Resection Versus Surgical Treatment for Early Rectal Cancer-

Yasumi Araki

Department of Surgery, Medical Center, Kurume University School of Medicine

In 142 patients with early rectal cancer and 78 with rectal creeping tumor, we evaluated the significance of endoscopic ultrasonography (EUS) in the preoperative diagnosis of cancer invasion and also compared different techniques: endoscopic mucosal resection and transanal endoscopic surgery. As a result, the diagnostic accuracy for depth of cancer invasion was increased to 87.9% with EUS (7.5 MHz), though protuberant lesions of 5 mm or more in height were difficult to diagnose because of tumor echo. Compared with endoscopic mucosal resection capable of removing tumors up to 2 cm in diameter, transanal endoscopic surgery proved to be more useful, as this technique was applicable to removing tumors up to 13 cm in diameter, was not influenced by tumor size or location and permitted resection with a sufficient safety margin.

Key words
endoscopic ultrasonography, endoscopic mucosal resection, transanal endoscopic microsurgery

Reprint requests
Yasumi Araki Department of Surgery, Medical Center, Kurume University School of Medidine
155-1 Kokubu, Kurume City, 839 JAPAN

Accepted
December 11, 1996

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