[Value of intraoperative ultrasonography in the surgical treatment of malignant tumors of the liver].
This retrospective study was designed to assess the specific contribution of intraoperative ultrasonography (IOU) in a series of 50 surgical procedures for malignant tumors of the liver (including 27 hepato-cellular carcinomas (HCC) secondary to cirrhosis and 18 metastases). Compared to conventional pre- and intra-operative investigations, IOU was more sensitive (81%) but less specific (27%) for detection of tumor nodules, but was inaccurate in detection of daughter nodules in hepato-cellular carcinomas (HCC) secondary to cirrhosis. The main specific contribution of IOU was assistance in performing surgery. In 14 cases (52%) of HCC secondary to cirrhosis, IOU provided one or several additional pieces of information which resulted in changes of the planned surgical procedure in 11 cases (41%) mainly enabling limited resection of small deep impalpable tumors. In 10 cases (37%), IOU directly guided resection (echo-guided segmentectomy or tumorectomy). Contribution of IOU was poor in primary carcinoma in non-cirrhotic liver, but in 8 cases of metastasis (44%) IOU provided additional information which resulted in changes of the intended surgical procedure in 5 cases (28%) mainly leading to a more extensive resection. Finally IOU was considered to be indispensable in 15 cases of HCC cirrhosis (56%) and in 5 cases of metastasis (28%).
Gouillat
C
C
Département de Chirurgie, Hôtel Dieu, Lyon.
Ben-Hayoun
E
E
Detry
L
L
Bérard
P
P
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D004067:Digestive System Neoplasms / Q000473:pathology; D006801:Humans; D007430:Intraoperative Care; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology / Q000556:secondary / Q000601:surgery; D012189:Retrospective Studies; D014463:Ultrasonography
Intérêt de l'échographie per-opératoire dans le traitement chirurgical des tumeurs malignes du foie.