title: Usefulness of intraoperative ultrasonography in liver resections due to colon cancer metastasis.
abstract: BACKGROUND
  Intraoperative ultrasonography (IOUS) of the liver has been used both as an aid for intraoperative anatomical definition and for the detection of new lesions. The present study aimed to evaluate the impact of IOUS and to identify factors that can predict the detection of new lesions intraoperatively.
  
  
  METHODS
  In this observational and prospective study, with a cross-sectional design, patients with colorectal cancer metastases who underwent hepatectomy were selected. Abdominal computed tomography, magnetic resonance imaging, and positron emission tomography were the preoperative evaluation tests. All patients underwent IOUS performed by the same surgeon. The intraoperative findings were compared with the preoperative tests results.
  
  
  RESULTS
  In total, 56 hepatectomies were evaluated. Half of the patients were men, with a mean age of 57 (30-85) years. New lesions were found intraoperatively in 12 patients (21.4% of cases) and were detected on both palpation and ultrasonography in 11 of these patients. Ultrasonography helped to revise the surgical plans by providing additional information in 35.7% of cases. On multivariate analysis, the presence of more than 4 preoperative nodules was predictive of the intraoperative occurrence of new lesions.
  
  
  CONCLUSIONS
  IOUS remains the only way to evaluate the relationships between tumors, liver vascular structures, and bile ducts intraoperatively. Alone, IOUS was not useful for identifying new lesions intraoperatively, as all new lesions were also detected on palpation. The number of lesions diagnosed on preoperative tests influenced the probability of identifying new lesions intraoperatively. There may be additional influential factors.
authors.affiliation: Department of Surgical Oncology, Hospital Santa Rita, do Complexo Hospitalar da Irmandade Santa Casa de Misericórdia de Porto Alegre (Rio Grande do Sul-Brazil) and Hepatology Post Graduate program (UFCSPA), Rua Dona Laura, 204 - 3 andar, Porto Alegre, RS, CEP: 90430090, Brazil. Electronic address: angelica_luc@hotmail.com.
authors.forename: Angélica Maria
authors.initials: AM
authors.lastname: Lucchese
authors.affiliation: Department of Surgical Oncology, Hospital Santa Rita, do Complexo Hospitalar da Irmandade Santa Casa de Misericórdia de Porto Alegre (Rio Grande do Sul-Brazil) and Hepatology Post Graduate program (UFCSPA), Rua Dona Laura, 204 - 3 andar, Porto Alegre, RS, CEP: 90430090, Brazil. Electronic address: ankalil@terra.com.br.
authors.forename: Antônio Nocchi
authors.initials: AN
authors.lastname: Kalil
authors.affiliation: Department of Surgical Oncology, Hospital Santa Rita, do Complexo Hospitalar da Irmandade Santa Casa de Misericórdia de Porto Alegre (Rio Grande do Sul-Brazil) and Hepatology Post Graduate program (UFCSPA), Rua Dona Laura, 204 - 3 andar, Porto Alegre, RS, CEP: 90430090, Brazil. Electronic address: alexfffcmpa@hotmail.com.
authors.forename: Alex
authors.initials: A
authors.lastname: Schwengber
authors.affiliation: Department of Radiology, Hospital Santa Rita, do Complexo Hospitalar da Irmandade da Santa Casa de Misericórdia de Porto Alegre/UFCSPA, Rua Prof. Annes Dias, 295, Centro Histórico, Porto Alegre, RS, CEP: 90020-090, Brazil. Electronic address: eiji.suwa@gmail.com.
authors.forename: Eiji
authors.initials: E
authors.lastname: Suwa
authors.affiliation: Department of Radiology, Hospital Santa Rita, do Complexo Hospitalar da Irmandade da Santa Casa de Misericórdia de Porto Alegre/UFCSPA, Rua Prof. Annes Dias, 295, Centro Histórico, Porto Alegre, RS, CEP: 90020-090, Brazil. Electronic address: gabrielmoura0301@gmail.com.
authors.forename: Gabriel Garcia
authors.initials: GG
authors.lastname: Rolim de Moura
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging* / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018084:Ultrasonography, Interventional
keywords: Colorectal cancer; Hepatectomy; Intraoperative; Liver; Ultrasonography