Endoscopy 2022; 54(S 01): S123-S124
DOI: 10.1055/s-0042-1744882
Abstracts | ESGE Days 2022
ESGE Days 2022 Digital poster exhibition

USEFULNESS OF CONTRAST-ENHANCED ENDOSCOPIC ULTRASOUND (CH-EUS) TO GUIDE THE TREATMENT CHOICE IN SUPERFICIAL RECTAL LESIONS: A CASE SERIES

G. Gibiino
1   Forlì-Cesena Hospitals, Ausl Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena, Italy
,
M. Sbrancia
1   Forlì-Cesena Hospitals, Ausl Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena, Italy
,
C. Binda
1   Forlì-Cesena Hospitals, Ausl Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena, Italy
,
C. Coluccio
1   Forlì-Cesena Hospitals, Ausl Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena, Italy
,
L. Saragoni
2   Ospedale G.B. Morgagni-L. Pierantoni, Forlì, Italy, UO Anatomia Patologica, Forlì, Italy
,
C. Fabbri
1   Forlì-Cesena Hospitals, Ausl Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena, Italy
› Author Affiliations
 

Aims Large rectal lesions can conceal submucosal invasion and cancer nodules. Despite the increasing diffusion of high-definition endoscopes in the Western countries and the importance of an accurate morphological evaluation, a complete assessment in this setting can be challenging.

Endoscopic ultrasound (EUS) plays an established role in the locoregional staging of rectum cancer although with a tendency to an over-estimation of the loco-regional (T)-staging. However, there are still few data on the possible use of contrast-enhanced endoscopic ultrasound (CH-EUS), especially if this ancillary technique may increase the accuracy for predicting invasive nodules among large rectal lesions.

Methods We performed a case series of consecutive large (≥20 millimiters) superficial rectal lesions assessed by CH-EUS.

Results From January 2020 to December 2021 we evaluated eight cases with high-definition endoscopy, characterized by focal areas suggestive for V type according to Kudo Classification. All lesions corresponded to sessile or Granular Lateral Spreading Tumors (LST-G), mixed type or not granular (LST-NG) according to Paris Classification, with size ranging from 30 to 180 mm.

We performed EUS using II generation contrast agent, Sonovue (©). Six cases, corresponding to invasive pattern at CH-EUS, were treated with surgery, confirmed as pT2 at final staging. Two cases, with non-invasive pattern at CH-EUS, underwent to curative endoscopic submucosal dissection (ESD) corresponding to pT1a tumors.

Conclusions CH-EUS can provide additional information for the characterization of rectal superficial lesions with focal areas suggestive for invasive cancer, by improving the performance of EUS in T1 staging.



Publication History

Article published online:
14 April 2022

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