Intra-operative ultrasound for detection of liver metastases from colorectal cancer.
OBJECTIVE
The aim of this study was to evaluate the accuracy of intra-operative ultrasound (IOUS) imaging in detecting liver secondaries at the time of primary colorectal surgery and to evaluate the impact of IOUS on patient management.


METHODS
Data from 167 patients with primary colorectal cancer who were admitted for elective surgery between January 1995 and December 2003 were prospectively evaluated and analysed. All patients underwent pre-operative abdominal ultrasonography (US) and computed tomography (CT), as well as IOUS. The final diagnosis of liver metastases was made by means of histological examination of either biopsy or surgical specimens. The sensitivities of pre-operative US and CT were compared with the sensitivity of IOUS, referred to histology. Changes in surgical management owing to IOUS findings were noted.


RESULTS
IOUS supplied additional information in the case of 31 patients. In 28 of these patients, this information had a major impact on the intra-operative strategy, in that the procedure was altered.


CONCLUSIONS
IOUS is safe, simple to perform and more accurate than pre-operative imaging. It reduces the number of patients subjected to superfluous surgery. The use of IOUS is therefore encouraged during colorectal cancer surgery.
Mazzoni
Gianluca
G
Department of Surgery, 'La Sapienza' University Medical School, Rome, Italy.
Napoli
Alessandro
A
Mandetta
Saverio
S
Miccini
Michelangelo
M
Cassini
Diletta
D
Gregori
Matteo
M
Colace
Lidia
L
Tocchi
Adriano
A
D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography