Abstract
Thirty-seven patients with rectal villous tumours were investigated by endorectal sonography to assess the integrity of the rectal muscularis propria at the tumour level. In four cases assessment of invasion was impossible. In 24 patients, endosonography revealed an ultrasonically superficial lesion not infiltrating the muscular layer. This was confirmed either, in the case of laser treatment, by the absence of malignant recurrence during the follow-up period or by histological examination after surgical resection. In nine patients, endosonography showed infiltration of the muscular layer. This was histologically confirmed in five operated patients. In the remaining four, laser destruction was performed: in two, a rectal adenocarcinoma was present 3 and 6 months later, respectively. These findings show that endosonography has a place in the management of rectal villous tumours, demonstrating invasive cancer in cases where other forms of assessment were wrongly reassuring.
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Brunetaud JM, Maunoury V, Chochelard D, Boniface B, Cortot A, Paris JC (1989) Endoscopic laser treatment for rectosigmoid villous adenoma: factors affecting the results. Gastroenterology 97:272–277
Mathus-Vliegen EMH, Tytgat GNJ (1986) Nd: YAG laser photocoagulation in colorectal adenoma. Evaluation of its safety, usefulness and efficacy. Gastroenterology 90:1865–1873
Low DE, Kozareck RA, Ball TJ, Ryan JA (1988) Nd: YAG laser photoablation of sessile villous and tubular adenomas of the colorectum. Ann Surg 208:725–732
Morson B (1976) Genesis of colo-rectal cancer. Clin Gastroenterol 5:505–525
Boscaini M, Masoni L, Montori A (1986) Transrectal ultrasonography: three years' experience. Int J Colorect Dis 1:208–211
Hildebrandt U, Feifel G, Schwartz HP, Scherr O (1986) Endorectal ultrasound: instrumentation and clinical aspects. Int J Colorect Dis 1:203–207
Christiansen J, Kirkegaard P, Ibsen J (1979) Prognosis after treatment of villous adenomas of the colon and rectum. Ann Surg 189:404–408
Fasano JJ (1984) Les tumeurs villeuses rectocoliques. Étude de 69 observations. Ann Gastroentérol Hépatol 20:315–323
Pradel E, Mot JC, Chemaly A (1967) Etude clinique et évolution des tumeurs villeuses du recto-sigmoïde. Arch Fr Mal App Dig 56:5–32
Schapiro S (1965) Villous papillomas of the rectum and colon. Selective therapy and surgicopathologic classification of 165 cases. Arch Surg 91:362–370
Shinya H, Wolff WI (1979) Morphology, anatomic distribution and cancer potential of colonic polyps. Ann Surg 190:679–683
Stulc JP, Petrelli NJ, Herrera L, Mittelman A (1988) Colorectal villous and tubuvillous adenomas equal or greater than four centimeters. Ann Surg 207:65–71
Welch JP, Welch CE (1976) Villous adenomas of the colorectum. Am J Surg 131:185–191
Fischer ER, Castro AF (1953) Diffuse papillomatous polyps (villous tumors) of the colon and rectum. Pathologic and clinical observations. Am J Surg 85:146–151
Nivatvongs S, Nicholson JD, Rothenberger DA, Balcos EG, Christenson CE, Nemer FD, Schottler JL, Goldberg SL (1980) Villous adenomas of the rectum. The accuracy of clinical assessment. Surgery 87:549–551
Adolff J, Kohler JJ (1969) Abord sacré de certaines tumeurs villeuses de l'ampoule rectale. J Chir (Paris) 98:19–26
Parks AG, Stuart AE (1973) The management of villous tumours of the large bowel. Br J Surg 60:688–695
Nicholls RJ, York Mason A, Morson BC, Dixon AK, Kelsey Fry I (1982) The clinical staging of rectal cancer. Br J Surg 69:404–409
Butch RJ, Stark DD, Wittenberg J, Tepper JE, Saini S, Simeone SF, Mueller PR, Ferucci JF (1986) Staging rectal cancer by MR and CT. Am J Rad 146:1155–1160
Hodgman CG, MacCarty RL, Wolf BG, May GR, Berquist TH, Sheedy PF, Beart RW, Spencer RJ (1986) Preoperative staging of rectal carcinoma by computed tomography and 0.15 T magnetic resonance imaging. Dis Colon Rectum 29:446–450
Thompson WM, Halvorsen RA, Foster WL, Roberts L, Gibbon R (1986) Preoperative and postoperative CT staging of rectosigmoid carcinoma. Am J Radiol 146:703–710
Beynon J, Foy DMA, Roe AM, Temple LN, Mortensen NJMcC (1986) Endoluminal ultrasound in the assessment of local invasion of rectal cancer. Br J Surg 73:474–477
Hildebrandt U, Feifel G (1985) Pre-operative staging of rectal cancer by intra-rectal ultrasound. Dis Colon Rectum 28:42–46
Konishi F, Muto T, Takahashi H, Itoh K, Kanazawa K, Morioka Y (1985) Transrectal ultrasonography for the assessment of invasion of rectal carcinoma. Dis Colon Rectum 28:889–894
Mosnier H, Guivarc'h M, Barbagelatta M (1987) L'échographie endorectale: appréciation de l'extension loco-régionale des cancers du rectum. Gastroentérol Clin Biol 11:307–311
Saitoh N, Okui K, Sarashina H, Suzuki M, Arai T, Nunomura M (1986) Evaluation of echographic diagnosis of rectal cancer using intrarectal ultrasonic examination. Dis Colon Rectum 29:234–242
Hildebrandt U, Feifel G, Dhom G (1987) The evaluation of the rectum by transrectal ultrasonography. Ultrasound Quarterly 1:265–277
Beynon J, Mortensen NJ, Foy DMA, Channer JL, Rigby H, Virjee J (1989) Preoperative assessment of mesorectal lymph node involvement in rectal cancer. Br J Surg 76:276–279
Nelson JC, Nimr A, Thomford NR (1987) Criteria for the selection of “early” carcinomas of the rectum. Arch Surg 122:533–536
Morson BC (1966) Factors influencing the prognosis of early cancer of the rectum. Proc R Soc Med 59:607–608
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Mosnier, H., Guivarc'h, M., Meduri, B. et al. Endorectal sonography in the management of rectal villous tumours. Int J Colorect Dis 5, 90–93 (1990). https://doi.org/10.1007/BF00298476
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DOI: https://doi.org/10.1007/BF00298476