Current value of intraoperative sonography during surgery for hepatic neoplasms

Zacherl, Johannes; Scheuba, Christian; Imhof, Martin; Zacherl, Maximilian; Längle, F.; Pokieser, Peter; Wrba, Fritz; Wenzl, E.; Mühlbacher, Ferdinand; Jakesz, R.; Steininger, R.

doi:10.1007/s00268-001-0266-2

Cited by 132 publications

(108 citation statements)

References 28 publications

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“…It allows for a very good characterization of focal liver lesions, with both sensitivity and specificity values over 90% [10][11][12][13][14]. Of the 73 patients included in the study in 41 (56.2%) patients the focal liver lesions found at IOUS were classified as malignant and in 32 (43.8%) patients the focal liver lesions found at IOUS were classified as benign.…”

Section: Discussionmentioning

confidence: 99%

The role of intraoperative ultrasound for the assessment of the focal liver lesions in patients with colorectal cancer

Damian

Rednic

Munteanu³

et al. 2014

Med Ultrason

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Objective: To evaluate the concordance between intraoperative ultrasound (IOUS) and abdominal ultrasound (US) for the characterization of focal liver lesions in patients with colorectal cancer, and to evaluate the way in which IOUS influences the initially established hepatic surgical protocol based on abdominal US only. Method: In this prospective study 73 patients with colorectal cancer and focal liver lesions found during IOUS were included. Abdominal US and IOUS findings were compared. The initially established hepatic surgical protocol based on abdominal US only was recorded. All patients in whom IOUS influenced this protocol and the way in which this was influenced were recorded. Results: Of the 73 patients, 41 (56.2%) had focal liver lesions classified as malignant by IOUS. In 26 of the 73 patients (35.6%), there were discordances between abdominal US and IOUS. IOUS influenced the operative protocol in 9 of the 73 patients included in the study (12.3%), and in 8 of the 41 patients with malignant lesions (19.5%). IOUS influenced the operative protocol by cancelling the preoperative hepatic surgery decision by evidencing the additional multiple malignant focal liver lesions, following the classification of some lesions as benign or by demonstrating the non-resectable character of other lesions. IOUS also determined unplanned hepatic resections by detecting resectable malignant lesions undiagnosed by abdominal US, and extended or limited the scheduled hepatic surgery based on abdominal US only. Conclusions: There were inconsistencies between IOUS and abdominal US, therefore in patients with colorectal cancer IOUS provided additional information about focal liver lesions. IOUS influenced the operative protocol and consequently, unnecessary liver surgery was avoided. Also, IOUS identified malignant resectable liver lesions which were undetected by abdominal US.

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Section: Discussionmentioning

confidence: 99%

The role of intraoperative ultrasound for the assessment of the focal liver lesions in patients with colorectal cancer

Damian

Rednic

Munteanu³

et al. 2014

Med Ultrason

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“…5,16 In addition, MRI has particular shortcomings that may contraindicate its use, such as the presence of metal prostheses and claustrophobia. 3,10 This may explain reports that IOUS detects lesions in up to 40% of patients not detected by PoI and alters surgical strategy in 25.7% of patients undergoing resection for CRlM. 5,16 The role of IoUS may be more important as laparoscopic liver surgery becomes more frequent due to the absence of intraoperative digital palpation.…”

Section: Discussionmentioning

confidence: 95%

“…3,[9][10][11][12] However, some earlier studies reported a limited clinical value of IoUS. 13,14 Regarding detection of liver lesions, PoI alone attains a sensitivity of 41-68% with transabdominal ultrasound, 60-75% with contrastenhanced CT and 80-85% with MRI.…”

Section: Discussionmentioning

confidence: 99%

The value of intraoperative ultrasound and preoperative imaging, individually and in combination, in liver resection for metastatic colorectal cancer

Lordan

Stenson

Karanjia

2011

annals

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INTRODUCTION Liver resection is proved to offer potential long-term survival for colorectal liver metastases (CRLM). Accurate radiological assessment is vital to enable an appropriate surgical approach. The role of intraoperative ultrasound (IOUS) has been controversial. This study was designed to analyse the accuracy of IOUS compared with that of preoperative imaging (POI) in these patients. MATERIALS AND METHODS A prospective analysis of 51 consecutive patients who underwent liver resection for CRLM was undertaken. The accuracy of POI and IOUS were correlated and compared with histopathological analysis. Statistical analyses included t-tests, to compare continuous variables, and chi-square and Fisher's exact tests to compare categorical variables. p<0.05 was considered significant RESULTS POI correlated with histology in 35 patients (68.6%). The sensitivity and specificity were 82.4% and 86.3% respectively. IOUS correlated with histology in 31 (60.8%) patients. The sensitivity and specificity were 84.3% and 76.5% respectively. There was no difference in accuracy between modalities. The accuracy of POI combined with IOUS correlated with histology in 40 patients (78.4%). The sensitivity and specificity were 88.2% and 84.3% respectively. The accuracy of combined modalities was significantly greater than IOUS or POI alone. CONCLUSIONS POI combined with IOUS may significantly increase the diagnostic accuracy of patients undergoing liver resection for CRLM.

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“…In hepatocellular carcinoma (HCC) IOUS allows detection of new lesions in 7% of cases at the primary hepatectomy and in 7.3% at the secondary hepatectomy [2]. In an analysis related to patients with colorectal liver metastases (CLM), sensitivity of computed tomography (CT) was 69.2%, of helical CT 82.5%, of magnetic resonance imaging (MRI) 84.9%, and of IOUS 95.2% [3]. CT and MRI cannot substitute the real time information provided by IOUS.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided liver resection: Early experience in a district general hospital

Grondona

Meola

Floris

et al. 2008

Journal of Ultrasound

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KEYWORDSIntraoperative ultrasonography; Liver resection; Hepatocellular carcinoma; Liver metastases.Abstract Introduction: Intraoperative ultrasonography (IOUS) is the gold standard for tumor staging and operative decision making in liver surgery. Providing dynamic information on tumorevessel relationships and distribution of intrahepatic veins, IOUS is also an important support for guiding the resection. Few authors report an extensive use of IOUS-guidance as a safe and effective approach. The aim of this study is to investigate the short-term results of an early experience of ultrasound (US) guided liver resection. Methods: From December 2005 to December 2007 an extensive use of IOUS-guided resection was applied in 11 consecutive patients (8 males and 3 females; median age 74 years). Perioperative data were collected prospectively to assess the influence of this approach on mortality, morbidity and early recurrence. Results: Four patients had hepatocellular carcinoma, 4 liver metastases, 1 peripheral cholangiocarcinoma, 1 hemangioma and 1 inflammatory pseudotumor. A median of 1 (range: 1e4) nodule per patient was resected. Median lesion size was 44 mm. Liver procedures included: 3 wedge resections, 3 subsegmentectomies, 4 segmentectomies and 3 bisegmentectomies. Median blood loss was 235 ml. Median surgical margin in cancer patients was 5 mm (range: 1e12). An average of 1 unit of blood transfusion was administered in 5 patients. Median postoperative hospital stay was 9 days. There was no mortality. Major complications occurred in 1 patient and minor complications in 5 patients. During a median follow-up of 14 months no recurrences were observed. Conclusions: In this study, use of IOUS-guided liver resection performed in a district general hospital proved to be a safe and effective approach in terms of short-term outcome.Sommario Premessa: Nell'ambito della chirurgia epatica l'ecografia intraoperatoria svolge un ruolo ben codificato nella stadiazione e nella pianificazione della strategia operatoria. L'importanza dell'ampio utilizzo di questa metodica anche durante la resezione è stata riportata solo da alcuni autori. Questo studio ha come scopo di verificare quali siano i risultati a breve termine di un ampio utilizzo dell'ecografia durante la resezione stessa in un ospedale periferico. Metodi: Nell'arco di 24 mesi 11 pazienti consecutivi sono stati sottoposti a resezione epatica ecoguidata. I dati perioperatori sono stati raccolti in modo prospettico per valutare l'influenza di questa metodica sulla mortalità, morbidità e recidive locali. * Corresponding author. via Peschiera 40/7, 16122 Genova, Italia.E-mail address: pietrogrondona@yahoo.com (P. Grondona). Risultati: Otto pazienti erano maschi. Età mediana 74 anni. Quattro HCC, 4 metastasi, 1 colangiocarcinoma periferico, 1 emangioma, 1 pseudotumore infiammatorio. Sono state eseguite 3 resezioni a cuneo, 3 subsegmentectomie, 4 segmentectomie e 3 bisegmentectomie. La perdita ematica mediana è stata 235 ml. In caso di tumore il margine di exeresi mediano è st...

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Current value of intraoperative sonography during surgery for hepatic neoplasms

Cited by 132 publications

References 28 publications

The role of intraoperative ultrasound for the assessment of the focal liver lesions in patients with colorectal cancer

The role of intraoperative ultrasound for the assessment of the focal liver lesions in patients with colorectal cancer

The value of intraoperative ultrasound and preoperative imaging, individually and in combination, in liver resection for metastatic colorectal cancer

Ultrasound-guided liver resection: Early experience in a district general hospital

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