Intra-operative Liver Ultrasound - a Contribution to Colorectal Carcinoma Staging

被引:6
|
作者
Skrovina, M. [1 ]
Bartos, J. [1 ]
Cech, B. [2 ]
Velkoborsky, M. [2 ]
Czudek, S. [1 ]
Kycina, R. [1 ]
Bartos, P. [1 ]
Adamcik, L. [1 ]
Konvicna, R. [2 ]
Soumarova, R. [3 ]
机构
[1] JG Mendel Oncol Ctr, Dept Surg, Novy Jicin 74101, Czech Republic
[2] JG Mendel Oncol Ctr, Dept Radiol, Novy Jicin 74101, Czech Republic
[3] JG Mendel Oncol Ctr, Dept Oncol, Novy Jicin 74101, Czech Republic
关键词
Colorectal cancer; intra-operative ultrasonography; liver metastases;
D O I
10.1080/00015458.2008.11680276
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background : Laparoscopic resection of colorectal carcinoma is now a well-established surgical technique with oncology treatment outcome similar to open surgery, yet performing better in some short-term variables. The technique, however, does not allow palpation of intra-abdominal organs and the liver in particular. This prospective study aims to assess the performance of laparoscopic intra-operative ulrasonography of the liver (L-IOUS) and compare its findings with pre-operative staging data. Methods : In total 70 patients, 53 men and 17 women, who were recruited into the study, were indicated for primary laparoscopic resection for colorectal carcinoma, with laparoscopic intra-operative ulrasonographic examination of the liver (L-IOUS) being used during the initial part of the operation. Before surgery, all patients underwent abdominal and pelvic contrast CT examinations. Ultrasonographic examination of the liver was included. Results : In 14 patients L-IOUS detected a synchronous metastatic lesion of the liver as opposed to only six patients with pre-operative CT-positive findings. Furthermore, CT-positive metastases in three patients were not confirmed by L-IOUS. Several patients were diagnosed with benign lesions not disclosed during pre-operative assessment, e.g. haemangioma in 5 vs 2 patients, focal nodular hyperplasia in 3 vs I patient and liver cysts in 7 vs 5 patients. Conclusion : Results of the presented prospective study substantiate the use of laparoscopic intra-operative ultrasound of the liver (L-IOUS) within the standard staging protocol, as this seems to appropriately supplement the results of the pre-operative staging. In cases of colorectal carcinoma the method allows highly sensitive detection of occult synchronous liver metastases that could finally alter a therapeutic strategy.
引用
收藏
页码:508 / 512
页数:5
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