A Prospective Study On Mon Local Recurrence Of Rectal Cancer After Surgery By Endoscopic Ultrasound

Objectives:By comparing endoscopic ultrasound(EUS),Magnetic resonance imaging(MRI),computed tomography(CT),fecal occult blood(FOB)and blood carcinoembryonic antigen(CEA)in monitoring postoperative local recurrence of rectal cancer,the effectiveness of EUS was evaluated.Methods:Patients with rectal cancer who underwent surgery in our hospital from January 2015 to December 2019 were enrolled in this prospective study.The clinical data of patients were recorded,including age,sex,stage of rectal cancer,mode of operation,past medical history(intestinal schistosomiasis,intestinal polyps,hypertension,diabetes,cardio-cerebrovascular diseases,etc.).All the postoperative patients with rectal cancer in the study were performed by senior doctors with more than 3 years of experience in EUS examination,and the examination time points were on 6 months,9 months,12 months and 18 months after operation.FOB,CEA,CT and MRI examination were performed at the same time.Results:A total of 415 patients were enrolled.14 patients had local recurrence.The median time of local recurrence after rectal cancer was 10.8±5.0(3-18)months,and the peak time was 6-12 months after operation.Among them,5 patients were complicated with distant metastasis(3 cases of pelvic metastasis,1 case of liver metastasis,1 case of liver and bone metastasis).Among the 14 patients with local recurrence,the specific recurrence sites were intestinal wall in 12 cases and external intestinal wall nodule in 2 cases.In this study the accuracy of EUS in recurrent rectal cancer cases was 100%,higher than the detection rates of MRI,CT,FOB and CEA.The positive accuracies of MRI,CT,FOB and CEA were 81.8%(x2=6.087,P=0.014),50%(x2=9.333,P=0.002),14.2%(x2=1,P=0.000),14.2%(x2=1,P=0.000)respectively,with significant differences when compared with EUS.Conclusion:The detection rate of EUS for local recurrence of rectal cancer after operation was significantly higher than that of MRI,CT,FOB and CEA,It was suggested that EUS should be the first choice for the examination of postoperative local recurrence of rectal cancer.However,MRI and CT were superior to EUS in monitoring postoperative distant metastasis.