The current role of intraoperative ultrasound during the resection of colorectal liver metastases: A retrospective cohort study

Sarah A. Knowles, Kimberly A. Bertens, Kristopher P. Croome, Roberto Hernandez-Alejandro

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)101-106
Number of pages6
JournalInternational Journal of Surgery
Volume20
DOIs
StatePublished - Aug 1 2015

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Cohort Studies
Retrospective Studies
Neoplasm Metastasis
Liver
Disease-Free Survival
Tumor Burden
Ultrasonography
Survival

Keywords

  • Colorectal cancer
  • Intraoperative ultrasound
  • Liver/hepatic metastases

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

The current role of intraoperative ultrasound during the resection of colorectal liver metastases : A retrospective cohort study. / Knowles, Sarah A.; Bertens, Kimberly A.; Croome, Kristopher P.; Hernandez-Alejandro, Roberto.

In: International Journal of Surgery, Vol. 20, 01.08.2015, p. 101-106.

Research output: Contribution to journalArticle

Knowles, Sarah A. ; Bertens, Kimberly A. ; Croome, Kristopher P. ; Hernandez-Alejandro, Roberto. / The current role of intraoperative ultrasound during the resection of colorectal liver metastases : A retrospective cohort study. In: International Journal of Surgery. 2015 ; Vol. 20. pp. 101-106.
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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.",
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