Prospective evaluation of different diagnostic techniques for the detection of liver metastases at the time of primary resection of colorectal carcinoma.
OBJECTIVE
To evaluate preoperative and operative methods of detecting liver metastases in patients undergoing primary resection for colorectal carcinoma.


METHODS
Prospective, open study.


METHODS
Teaching hospital, Germany.


METHODS
51 Patients with confirmed primary colorectal carcinoma.


METHODS
Computed tomography during arterial portography (CT-AP), percutaneous ultrasonography (US), operative palpation and examination of the liver, operative US, and computed tomography (CT) follow-up 6-12 months postoperatively.


METHODS
Sensitivity, specificity, positive and negative predictive value, and accuracy.


RESULTS
Overall accuracy was worst for CT during portography, because of the diagnosis of many false positive lesions. Exploration and palpation of the liver had the highest sensitivity (83%) and specificity (100%), and operative US did not give any useful additional information.


CONCLUSIONS
Preoperative percutaneous US is recommended as the best non-invasive screening test; otherwise careful inspection and palpation during operation are sufficient for the evaluation of the liver during primary resection for colorectal carcinoma.
Nies
C
C
Department of General Surgery, Phillipps-University Marburg, Germany.
Leppek
R
R
Sitter
H
H
Klotter
H J
HJ
Riera
J
J
Klose
K J
KJ
Schwerk
W B
WB
Rothmund
M
M
D003110:Colonic Neoplasms / Q000601:surgery*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D010173:Palpation; D011172:Portography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D012680:Sensitivity and Specificity; D012811:Sigmoid Neoplasms / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography