[Usefulness of intraoperative ultrasonography of the liver in patients with colorectal adenocarcinoma].
Surgery is the treatment of choice of colorectal cancer metastases to the liver. Hepatic resection was associated with 5-year survival rate of 20-40%, mainly due to accurate staging of the neoplasm. Intraoperative ultrasonography is regarded as the most accurate technique for detecting and localising hepatic tumours, primary or metastatic. The purpose of this study was to evaluate the usefulness of the intraoperative ultrasonography (IUS) in the detection of new, synchronous metastases in patients with colorectal carcinoma.


METHODS
High resolution operative ultrasound scanning using B-mode real time apparatus (Toshiba SSA-220A: Toshiba, Tokyo, Japan) with 7.5 MHz T-type transducer was performed in 82 patients electively operated on for colorectal carcinoma. We evaluated the size, number, and site of the lesions and the relationship of the tumour to the intrahepatic vessels. In 9 patients metastatic lesions were diagnosed preoperatively (abdominal US and CT).


RESULTS
Intrahepatic lesions were found in 26 (31%) patients operated on--18 (22%) patients had metastatic tumours, in 8 patients benign lesions were detected. In 9 operations intraoperative ultrasonography identified previously unrecognised lesions--solitary liver metastasis in 2 patients, two small metastases in 1 patient, additional metastases in 4 patients and benign lesions in 2 patients. The use of IUS modified the extent of surgery in 4 patients--three patients were found to have inoperable disease, therefore hepatic resection was abandoned, one patient was found to have additional lesions and the extent of the resection was modified. Lymph node metastases were found in 3 patients.


CONCLUSIONS
Intraoperative ultrasonography is a safe and simple method and its high diagnostic efficiency encourages its routine use during colorectal surgery.
Kaczmarek
Bartosz
B
Oddział Kliniczny Chirurgii Ogólnej i Transplantacyjnej Samodzielnego Publicznego Szpitala Klinicznego Nr 2 w Szczecinie.
Pełka
Beata
B
Ostrowski
Marek
M
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D012189:Retrospective Studies; D014463:Ultrasonography