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01-11-2013

Intraoperative Liver Ultrasound Still Affects Surgical Strategy for Patients with Colorectal Metastases in the Modern Era

Authors: Alessandro Ferrero, Serena Langella, Felice Giuliante, Luca Viganò, Maria Vellone, Giuseppe Zimmitti, Francesco Ardito, Gennaro Nuzzo, Lorenzo Capussotti

Published in: World Journal of Surgery | Issue 11/2013

Abstract

Background

The present study was designed to evaluate the role of intraoperative ultrasound (IOUS) in intrahepatic staging and the impact on surgical strategy for patients with colorectal liver metastases (CRLM).

Methods

The study included 515 patients who had undergone liver resection for CRLM at two tertiary care referral centers. Data from a prospectively collected database were retrospectively analysed. Early intrahepatic recurrence was assessed at 3 and 6 months after resection and was considered as residual disease undetected by IOUS. Performance of imaging modalities was compared by analysis of studies on individual patients.

Results

A total of 1,370 liver metastases were detected preoperatively with a median of 3 imaging modalities. MRI and PET were performed in 51 and 42 % of the patients, respectively. Median number of days between last imaging and surgery was 18. Contrast-enhanced IOUS was performed in 136 patients (26.4 %). Intraoperatively, 293 new nodules were found in 132 patients: on histology 280 were CRLM (17.6 %). Surgical strategy was changed in 140 patients (27.2 %). On multivariate analysis synchronous and bilobar metastases ≥3 in number, BMI ≥30, and time between last imaging and surgery longer than 18 days resulted in predictive factors indicating new nodules detected by IOUS. Early intrahepatic recurrences were 3.7 and 7.9 % at 3 and 6 months. Performance of CT, MRI, FDG-PET, and intraoperative staging was compared: sensitivity was 63.6, 68.8, 53.6, and 92 % and specificity was 91, 92.3, 95.8, and 97.8 %, respectively

Conclusions

The use of IOUS continues to be mandatory for correct staging of patients with CRLM undergoing liver resection.

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Title: Intraoperative Liver Ultrasound Still Affects Surgical Strategy for Patients with Colorectal Metastases in the Modern Era
Authors: Alessandro Ferrero
Serena Langella
Felice Giuliante
Luca Viganò
Maria Vellone
Giuseppe Zimmitti
Francesco Ardito
Gennaro Nuzzo
Lorenzo Capussotti
Publication date: 01-11-2013
Publisher: Springer US
Published in: World Journal of Surgery / Issue 11/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-013-2183-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intraoperative Liver Ultrasound Still Affects Surgical Strategy for Patients with Colorectal Metastases in the Modern Era

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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