The current role of intraoperative ultrasound during the resection of colorectal liver metastases: A retrospective cohort study. (August 2015)

• Record Type: Journal Article
• Authors: Knowles, Sarah A.; Bertens, Kimberly A.; Croome, Kristopher P.; Hernandez-Alejandro, Roberto
• Is Part Of: International journal of surgery. Volume 20(2015)
• Page Start: 101
• Page End: 106
• Publication Date: 2015-08
• Subjects: Colorectal cancer -- Liver/hepatic metastases -- Intraoperative ultrasound; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2015.05.052
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Introduction: Liver resections with negative margins improve survival in patients with colorectal liver metastases (CRLM). Intraoperative ultrasound (IOUS) is a valuable tool that gives information about lesions that ultimately changes surgical strategy to ensure complete removal, which subsequently improves disease free survival (DFS). Methods: A retrospective review of patients who underwent a resection for CRLM from 2009 to 2012 was completed to determine the impact of IOUS. Results: A total of 103 patients had a hepatic resection for CRLM. All patients had preoperative imaging to assist with operative planning. IOUS was performed in 72 cases. Surgical strategy changed in 31 (43.1%) cases with IOUS, compared to three (9.7%) with no IOUS ( P < 0.001). A new lesion was detected in 13 (18.1%) of the cases. A higher proportion of nonanatomic liver resections were performed in the IOUS group (N = 27, 37.5%) compared to the non-IOUS group (N = 6, 19.4%) ( P = 0.07). Conclusion: Achievement of a negative resection margin was comparable between the two groups. However, there was a trend toward improved DFS in the IOUS group. Despite advances in preoperative imaging, IOUS demonstrates utility in providing novel information that allows removal of the entire tumor burden, using parenchymal-preserving techniques when feasible, leading to improved DFS. Highlights: We examine intraoperative ultrasound use for resection of colorectal liver metastases. IOUS provides information about lesions that can change in the operative plan. There is a trend toward improved disease free survival in the IOUS group. Despite improvement in preoperative imaging, IOUS still plays an important role.