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The use of intra‐operative endo‐anal ultrasound in perianal disease
Author(s) -
Tilney H. S.,
Heriot A. G.,
Trickett J. P.,
Massouh H.,
Edwards D. P.,
Mellor S. G.,
Gudgeon A. M.
Publication year - 2006
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2006.00927.x
Subject(s) - medicine , anus neoplasms , ultrasound , anus diseases , anal canal , radiology , surgery , rectum
Endoanal ultrasound (EAUS) has demonstrated high sensitivity and specificity for the structural imaging of anorectal pathology. This study prospectively assessed the impact of intra‐operative EAUS on the surgical management of perianal disease. Methods EAUS was performed prior to and after examination under anaesthesia (EUA) in a consecutive series of patients with perianal disease. The impact of EAUS on the surgery performed was identified. Results Forty‐three procedures have been performed in 38 patients (21 male, 17 female; mean age 42.7 years, range 6–76 years) over a three year period. Pathologies encountered were fistula‐in‐ano (42%), fissure‐in‐ano (26%), complicated perianal sepsis (16%) and carcinoma (5%). No specific abnormality was identified in 5 symptomatic patients (12%). Four patients with fissures had undergone previous sphincterotomy. In 22 cases (51.2%) the EAUS findings affected the surgical management (extent of muscle above a fistula 9 cases, extent of sphincterotomy 7 cases, site of sepsis identified 2 cases, exclusion of sepsis 2 cases, assessment of cancer resectability 1 case, biopsy of intersphincteric lesion 1 case). Conclusion Intra‐operative EAUS accurately identifies perianal disease and influences the surgical procedure performed. While not essential, it is a useful adjunct especially in recurrent perianal sepsis, undiagnosed anorectal pain and anal fissure.