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.
Similar content being viewed by others
References
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.
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.
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.
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.
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.
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.
Chandler WF, Knake JE, McGillicuddy JE, Lillehei KO, Silver TM. Intraoperative use of real-time ultrasonography in neurosurgery. J Neurosurg 1982;57:157–63.
Rubin JM, Dohrmann GJ. The spine and spinal cord during neurosurgical operations: real-time ultrasonography. Radiology 1985;155:197–200.
Sigel B, Machi J, Ramos JR, Duarte B, Donahue PE. The role of imaging ultrasound during pancreatic surgery. Ann Surg 1984;200:486–93.
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.
Yumoto Y, Jinno K, Tokuyama K, et al. Hepatocellular carcinoma detected by iodized oil. Radiology 1985;154:19–24.
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.
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.
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.
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.
Glen PM, Noseworthy J, Babcock DS. Use of intraoperative ultrasonography to localize a hepatic abscess. Arch Surg 1984;119:347–8.
Machi J, Sigel B, Beitler JC, et al. Ultrasonic examination during surgery for abdominal abscess. World J Surg 1983;7:409–15.
Wilson SM, Adson MA. Surgical treatment of hepatic metastases from colorectal cancers. Arch Surg 1976;111:330–4.
Cady B, McDermott WV. Major hepatic resection for metachronous metastases from colon cancer. Ann Surg 1985;201:204–9.
Adson MA, van Heerden JA, Adson MH, Wagner JS, Ilstrup DM. Resection of hepatic metastases from colorectal cancer. Arch Surg 1984;119:647–51.
Sterchi JM. Hepatic artery infusion for metastatic neoplastic disease. Surg Gynecol Obstet 1985;160:477–89.
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.
Author information
Authors and Affiliations
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
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02555061