A Preoperative Assessment Of EUS:in The Laparoscopic Surgery Of Rectosigmoid Endometriosis

Aims: The intestinal tract is a common site of endometriosis.Endoscopic ultrasonography has been regarded as a method for the detection of colorectal endometriosis recently.The purpose of this study was to compare the diagnostic efficiency of EUS and MRI for colorectal endometriosis,develop preoperative examination strategies,improve the accuracy of surgical planning,and avoid the waste of clinical resources.We summarized the relationship between EUS performance and actual operation mode,and evaluated the preoperative evaluation value of EUS examination for laparoscopic treatment of colorectal endometriosis.Methods: Retrospective analysis was Performed on 113 Patients diagnosed with deep endometriosis in Shenzhen People's hospital from January 2016 to March 2018.General data,Preoperative examination results and surgical data were collected.The efficiency of EUS and MRI was compared,and the microscopic manifestations(such as lesion location,size and depth)and surgical methods of all EUS cases were counted for discriminant analysis.Results: 1.The incidence of intestinal symptoms in patients with colorectal endometriosis(69.1%)was higher than that in patients with non-colorectal endometriosis(44.4%)(P < 0.05).2.There was no significant difference in the levels of CA199(24.12 vs.17.28)and CA125(63.68 vs.63.53)in the colorectal invasion group and the non-colorectal invasion group.(P > 0.05)3.Absence of EUS examination is a risk factor for inaccurate surgical planning OR=4.01;95% CI,(1.77 10.00)4.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of EUS for diagnosis of colorectal endometriosis(93.9%(46/49),64.3%(18/28),82.1%(46/56),85.7%(18/21),83.1%(64/77))are superior to MRI(61.2(30/49),85.7(24/28),88.2(30/34),45.3(24/53),70.1(54/77)in determining the depth of lesion infiltration.5.According to the comparison of the diagnostic efficiency of MRI and EUS in colorectal lesions of different sizes and depths,the preoperative examination flow chart was developed.6.According to the number of lesions,the depth and the length and diameter of lesions under EUS,the discriminant analysis formula for the selection of surgical methods can be obtained.Conclusion: The diagnostic efficiency of EUS for colorectal endometriosis is superior to that of MRI,which has obvious advantages in judging the depth of lesion invasion.According to the number of lesions,the length and depth of lesions in EUS examination,the relevant discriminant analysis formula can effectively predict the surgical method.