World Journal of Laparoscopic Surgery

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VOLUME 2 , ISSUE 3 ( September-December, 2009 ) > List of Articles

REVIEW ARTICLE

Laparoscopic versus Intraoperative Ultrasound in the Diagnostic of Liver Tumors

María A Matamoros

Citation Information : Matamoros MA. Laparoscopic versus Intraoperative Ultrasound in the Diagnostic of Liver Tumors. World J Lap Surg 2009; 2 (3):43-46.

DOI: 10.5005/jp-journals-10007-1035

Published Online: 01-12-2009

Copyright Statement:  Copyright © 2009; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Intraoperative ultrasound has become the gold standard complementary study to surgical decision making in liver surgery. In this review are analyze different variables to identified if laparoscopy ultrasound findings are equal or better than intraoperative ultrasound.

Methods

A literature search was performed using Medline and Highwire Press data base. The following search terms were use: “laparoscopic ultrasonography”, “intraoperative ultrasonography” and “liver tumors”. 447 citations found in total. Criteria for selection of literature were number of cases (excluded if less than 20), Ultrasonography studies IOU and LU of different types of tumors: neuroendorcrine, HCC and colon metastasis were included, and method of analysis (statistical or nonstatistical).

Results

The variables analyze in the studies selected were as follows: Method of patients selection, operative technique, operating time, irresectability, postoperative morbidity, number of new tumors missed by IOU or LIOU, surgical plan changed after IOU or LIUO and Hospital stay. Patient's selection was based in patient having any type of liver tumor. Operative technique was performed in cases of IOU by conventional laparotomy, and in laparoscopy cases were use mainly 2 subcostal ports and the umbilical port. Operating time was estimated surgical prolongation of 30 minutes in the laparoscopy cases. Morbidity was lower in LIOU cases than in IOU. Lesions missed by LIOU and IOU, both methods showed a higher sensitivity in finding small lesions than other complementary diagnostic studies. Hospital stay was considerable shorter in LIOU.

Conclusions

Laparoscopy ultrasound has demonstrated to be very useful in diagnostic of liver tumor lesions. Therefore, there is big room for the LIOU improved in diagnostic liver tumors. New and improved LIOU probes would very soon allow similar findings than IOU. Targeting laparoscopy to patients at high risk for unresectable disease requires consideration to avoid unnecessary laparotomy.

Aim and objectives

The aim of this study is to compare the effectiveness of laparoscopic ultrasonography (LU) versus the open intraoperative ultrasonography.

The following parameters were evaluated for both IOU and LIOU:

1. Method of patients selection.

2. Operative technique.

3. Operating time.

4. Intraoperative and postoperative complications.

5. Postoperative morbidity.

6. Number of new tumors missed by IOU or LIOU.

7. Surgical plan changed after IOU or LIUO.

8. Hospital stay.

Material and methods

A literature search was performed using Medline and Highwire Press data base. The following search terms were use: “laparoscopic ultrasonography”, “intraoperative ultrasonography” and “liver tumors”. 447 citations found in total. Selected papers were screened for further references. Criteria for selection of literature were number of cases (excluded if less than 20), Ultrasonography studies IOU and LU of different types of tumors: Neuroendocrine, HCC and colon metastasis were included, and method of analysis (statistical or nonstatistical).


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  1. Practice/ Clinical Guidelines published on: 03/2009(by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).
  2. Hansen. The Evolving Role of Staging Laparoscopy in the Treatment of Colorectal Hepatic Metastasis Arch Surg/ Vol 140, Aug 2005.
  3. The evolving influence of laparoscopy and laparoscopic ultrasonography on patients with hepatocellular carcinoma. Am J Surg. Nov 2008;196(5):736-40.
  4. Arch Surg. 2007;142(12):1170-75.
  5. Laparoscopic US-guided radiofrequency ablation of unresectable hepatocellular carcinoma in liver cirrhosis: Feasibility and clinical outcome. J Laparoendosc Adv Surg Tech A. Dec 2008;18 (6):797-801.
  6. Diagnostic Laparoscopy for Primary and Secondary Liver Malignancies: Impact of Improved Imaging and Changed Criteria for Resection . Annals of Surgical Oncology, 11(5):522-29.
  7. Echogenicity of Liver Metastases is an Independent Prognostic Factor After Potentially Curative Treatment. Arch Surg 2000;135:1285-90.
  8. Patient Variability in Intraoperative Ultrasonographic Characteristics of Colorectal Liver Metastases. Arch Surg 2008;143(1):29-34.
  9. Staging Laparoscopy for Potentially Resectable Noncolorectal, Nonneuroendocrine Liver Metastases. Annals of Surgical Oncology 9(2):204-09.
  10. The Role of Staging Laparoscopy in Hepatobiliary Malignancy: Prospective Analysis of 401 Cases. Annals of Surgical Oncology 10(2):183-89.
  11. Hansen. The Evolving Role of Staging Laparoscopy in the Treatment of Colorectal Hepatic Metastasis. Arch Surg. Aug 2005;140.
  12. Intra-operative liver ultrasound: A contribution to colorectal carcinoma staging. Acta Chir Belg. Sep-Oct 2008;108(5):508-12.
  13. The routine use of intraoperative ultrasound in patients with colorectal cancer improves the detection of hepatic metastases. Colorectal Dis. 2006 Mar;8(3):192-94.
  14. F Di Metachronous liver metastases and resectability: Fong's score and laparoscopic evaluation . HPB, 2008;10:13-17.
  15. Published on: 03/2009 by the Society of American Gastrointestinal and Endoscopic Surgeons SAGES)
  16. WR The Role of Staging Laparoscopy in Hepatobiliary Malignancy: Prospective Analysis of 401 Cases. Annals of Surgical Oncology 10(2):183-89.
  17. RS Laparoscopic staging and tumor ablation for hepatocellular carcinoma in Child C cirrhotics evaluated for orthotopic liver transplantation.
  18. Portal-phase contrast-enhanced helical CT for the detection of malignant hepatic tumors: Sensitivity based on comparison with intraoperative and pathologic findings. AJR Am J Roentgenol 1996;166:91-95.
  19. Intraoperative ultrasonography in detecting and assessment of colorectal liver metastases. Scand J Surg 2007;96(1):51-55.
  20. Current value of intraoperative sonography during surgery for hepatic neoplasms. World J Surg. May 2002;26(5):550-54.
  21. Intraoperative ultrasound (IOUS) is essential in the management of metastatic colorectal liver lesions. Am Surg. Jul 2000;66(7):611-15.
  22. Ryan; Jeffrey M. Pearl; Allan E. Siperstein. Laparoscopic Ultrasound vs Triphasic Computed Tomography for Detecting Liver Tumors. Arch Surg/ Aug 2000;135.
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