[Role of intra-operative echography and computed tomography with multiple detectors in the surgery of hepatic metastases: a prospective study].
OBJECTIVE
To study the performance of the intraoperative ecography in the diagnosis of new liver metastases in the era of computerized tomography (CT) with multidetectors and its impact on the surgical operation.


METHODS
Between February 2005 and April 2006 patients with resectable liver metastases where studied prospectively in a multidisciplinary meeting (surgeons, radiologist, oncologist). The preoperative CT findings were compared with the intraoperative findings and ultrasound study and the results of the surgical operation.


RESULTS
Forty-five candidates for curative surgery had a total of 171 hepatic lesions. CT correctly detected 115 lesions with a sensitivity of 67%, and a positive predictive value of 97%, with a false negative rate of 33% and false positive rate of 2%. In 5 patients intraoperative findings were the cause of changing the surgical procedure, three patients were unresectable (rate of resectability of 93%) and two patients needed a larger hepatic resection.


CONCLUSIONS
CT with multidetectors and multidisciplinary meetings are the most important factors in the decision making of surgery of liver metastases with a high resectability rate. Intraoperative ecography is useful for the detection of 10% more liver metastases, but rarely involves a change in the surgical procedure.
Figueras
Joan
J
Servicio de Cirugía General y Digestiva, Hospital Universitario de Girona Dr. Josep Trueta, Girona, España. info@jfigueras.net
Planellas
Pere
P
Albiol
Maite
M
López-Ben
Santiago
S
Soriano
Jordi
J
Codina-Barreras
Antoni
A
Pardina
Berta
B
Rodríguez-Hermosa
Jose Ignacio
JI
Falgueras
Laia
L
Ortiz
Rosa
R
Maroto
Albert
A
Codina-Cazador
Antonio
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional