Skip to main content
Log in

Detection of unrecognized liver metastases from colorectal cancers by routine use of operative ultrasonography

  • Published:
Diseases of the Colon & Rectum

Abstract

The importance of diagnosis and detection of liver metastases cannot be overemphasized for the treatment and prognosis of colorectal cancers. As a new diagnostic technique, operative ultrasonography has been performed during 33 operations for colorectal cancers including three operations for metachronous liver metastases. Of these, in five patients (15.2 percent) ultrasonography using 5- or 7.5-MHz instruments identified metastatic tumors that had not been diagnosed during preoperative imaging studies or at exploration. Most of these tumors were approximately 1 cm in size and nonpalpable. Cases of these five patients are presented in this report. High-resolution operative ultrasonography is considered to be a valuable method for detection of unrecognized metastatic tumors and for precise localization and spatial assessment of these hepatic lesions. Because it is safe, simple, and highly sensitive, the routine use of operative ultrasound is encouraged during surgery upon colorectal cancers for systematic screening of metastatic liver tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Umpleby HC, Bristol JB, Rainey JB, Williamson RC, Chir M. Survival of 727 patients with single carcinomas of the large bowel. Dis Colon Rectum 1984;27:803–10.

    Article  PubMed  CAS  Google Scholar 

  2. Malcolm AW, Perencevich NP, Olson RM, Hanley JA, Chaffey JT, Wilson RE. Analysis of recurrence patterns following curative resection for carcinoma of the colon and rectum. Surg Gynecol Obstet 1981;152:131–6.

    PubMed  CAS  Google Scholar 

  3. Gilbert JM, Jeffrey I, Evans M, Kark AE. Sites of recurrent tumour after “curative” colorectal surgery: implications for adjuvant therapy. Br J Surg 1984;71:203–5.

    PubMed  CAS  Google Scholar 

  4. Gianola FJ, Dwyer A, Jones AE, Sugarbaker PH. Prospective studies of laboratory and radiologic tests in the management of colon and rectal cancer patients: I. Dis Colon Rectum 1984;27:811–8.

    Article  PubMed  CAS  Google Scholar 

  5. Smith TJ, Kemeny MM, Sugarbaker PH, et al. A prospective study of hepatic imaging in the detection of metastatic disease. Ann Surg 1982;195:486–91.

    Article  PubMed  CAS  Google Scholar 

  6. Temple DF, Parthasarathy KL, Bakshi SP, Mittelman AE. A comparison of isotopic and computerized tomographic scanning in the diagnosis of metastasis to the liver in patients with adenocarcinoma of the colon and rectum. Surg Gynecol Obstet 1983;156:205–8.

    PubMed  CAS  Google Scholar 

  7. Chandler WF, Knake JE, McGillicuddy JE, Lillehei KO, Silver TM. Intraoperative use of real-time ultrasonography in neurosurgery. J Neurosurg 1982;57:157–63.

    Article  PubMed  CAS  Google Scholar 

  8. Rubin JM, Dohrmann GJ. The spine and spinal cord during neurosurgical operations: real-time ultrasonography. Radiology 1985;155:197–200.

    PubMed  CAS  Google Scholar 

  9. Sigel B, Machi J, Ramos JR, Duarte B, Donahue PE. The role of imaging ultrasound during pancreatic surgery. Ann Surg 1984;200:486–93.

    Article  PubMed  CAS  Google Scholar 

  10. Sigel B, Duarte B, Coelho JC, Nyhus LM, Baker RJ, Machi J. Localization of insulinomas of the pancreas at operation by real-time ultrasound scanning. Surg Gynecol Obstet 1983;156:145–7.

    PubMed  CAS  Google Scholar 

  11. Yumoto Y, Jinno K, Tokuyama K, et al. Hepatocellular carcinoma detected by iodized oil. Radiology 1985;154:19–24.

    PubMed  CAS  Google Scholar 

  12. Konno T, Maeda H, Iwai K, et al. Selective targeting of anti-cancer drug and simultaneous image enhancement in solid tumors by arterially administered lipid contrast medium. Cancer 1984;54:2367–74.

    Article  PubMed  CAS  Google Scholar 

  13. Chapuis PH, Fisher R, Dent OF, Newland RC, Pheils MT. The relationship between different staging methods and survival in colorectal carcinoma. Dis Colon Rectum 1985;28:158–61.

    PubMed  CAS  Google Scholar 

  14. Makuuchi M, Hasegawa H, Yamazaki S. Intraoperative ultrasonic examination for hepatectomy. In: Lerski RA, Morley P, eds. Ultrasound '82. Oxford: Pergamon Press, 1982:493–7.

    Google Scholar 

  15. Hamano K, Akimoto S, Yuri T, et al. Intraoperative ultrasonography: an aid to hepatectomy for liver metastases from colorectal cancer. J Exp Clin Cancer Res 1984;3:143–7.

    Google Scholar 

  16. Glen PM, Noseworthy J, Babcock DS. Use of intraoperative ultrasonography to localize a hepatic abscess. Arch Surg 1984;119:347–8.

    PubMed  CAS  Google Scholar 

  17. Machi J, Sigel B, Beitler JC, et al. Ultrasonic examination during surgery for abdominal abscess. World J Surg 1983;7:409–15.

    Article  PubMed  CAS  Google Scholar 

  18. Wilson SM, Adson MA. Surgical treatment of hepatic metastases from colorectal cancers. Arch Surg 1976;111:330–4.

    PubMed  CAS  Google Scholar 

  19. Cady B, McDermott WV. Major hepatic resection for metachronous metastases from colon cancer. Ann Surg 1985;201:204–9.

    Article  PubMed  CAS  Google Scholar 

  20. Adson MA, van Heerden JA, Adson MH, Wagner JS, Ilstrup DM. Resection of hepatic metastases from colorectal cancer. Arch Surg 1984;119:647–51.

    PubMed  CAS  Google Scholar 

  21. Sterchi JM. Hepatic artery infusion for metastatic neoplastic disease. Surg Gynecol Obstet 1985;160:477–89.

    PubMed  CAS  Google Scholar 

  22. Riether RD, Khubchandani IT, Sheets JA, Stasik JJ, Rosen L. A prospective study of continuous hepatic perfusion with implantable pump. Dis Colon Rectum 1985;28:24–6.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Machi, J., Isomoto, H., Kurohiji, T. et al. Detection of unrecognized liver metastases from colorectal cancers by routine use of operative ultrasonography. Dis Colon Rectum 29, 405–409 (1986). https://doi.org/10.1007/BF02555061

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02555061

Key words

Navigation