title: [Role of intra-operative echography and computed tomography with multiple detectors in the surgery of hepatic metastases: a prospective study].
abstract: 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.
authors.affiliation: Servicio de Cirugía General y Digestiva, Hospital Universitario de Girona Dr. Josep Trueta, Girona, España. info@jfigueras.net
authors.forename: Joan
authors.initials: J
authors.lastname: Figueras
authors.forename: Pere
authors.initials: P
authors.lastname: Planellas
authors.forename: Maite
authors.initials: M
authors.lastname: Albiol
authors.forename: Santiago
authors.initials: S
authors.lastname: López-Ben
authors.forename: Jordi
authors.initials: J
authors.lastname: Soriano
authors.forename: Antoni
authors.initials: A
authors.lastname: Codina-Barreras
authors.forename: Berta
authors.initials: B
authors.lastname: Pardina
authors.forename: Jose Ignacio
authors.initials: JI
authors.lastname: Rodríguez-Hermosa
authors.forename: Laia
authors.initials: L
authors.lastname: Falgueras
authors.forename: Rosa
authors.initials: R
authors.lastname: Ortiz
authors.forename: Albert
authors.initials: A
authors.lastname: Maroto
authors.forename: Antonio
authors.initials: A
authors.lastname: Codina-Cazador
mesh_terms: 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