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Gastroenterologie up2date 2017; 13(02): 123-134
DOI: 10.1055/s-0043-110596
Wichtige Methoden in der Gastroenterologie
Georg Thieme Verlag KG Stuttgart · New York

Rektale Endosonografie – Stellenwert in der Gastroenterologie

Christian Jürgensen
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Publication History

Publication Date:
29 June 2017 (online)

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Update of:

Rektale EndosonografieGastroenterologie up2date 2012; 8(01): 45-57
DOI: 10.1055/s-0031-1291730

Seit der Erstbeschreibung des transanalen Ultraschalls 1956 zur Untersuchung der Prostata ergaben sich im Lauf der letzten Jahrzehnte zahlreiche weitere Indikationen für den Einsatz der rektalen Endosonografie. Dieser Beitrag zeigt die Möglichkeiten, aber auch die Grenzen dieser Untersuchungsmethode in der Gastroenterologie.
Kernaussagen

  • Die rektale Endosonografie ist entsprechend der deutschen S3-Richtlinie im Rahmen des präoperativen Stagings des Rektumkarzinoms empfohlen, wenn der Verdacht auf ein T1-Stadium besteht [8].

  • Sie ermöglicht eine Differenzierung auch von frühen Tumorstadien und erlaubt, einen Lymphknotenbefall durch Feinnadelpunktion zu sichern.

  • Die konkurrierende MRT kann frühe Tumorstadien schlechter differenzieren, stellt aber die insbesondere bei fortgeschrittenen Tumoren wichtige mesorektale Faszie dar.

  • Die Beurteilung einer Lymphknotenbeteiligung gelingt durch beide Methoden nicht befriedigend.

  • Die Endosonografie kann für die Nachsorge des Rektumkarzinoms eingesetzt werden.

Schlüsselwörter

Rektale Endosonografie - Indikationen - Rektumkarzinom - Staging - TNM-Klassifikation
 

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