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Contrast-enhanced intraoperative ultrasonography during hepatectomies for colorectal cancer liver metastases

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Preliminary reports showed that contrast-enhanced intraoperative ultrasonography (CEIOUS) provides information on primary or metastatic tumors of the liver that is not obtainable with conventional intraoperative ultrasonography (IOUS). This study validates the impact of CEIOUS, focusing on resective surgery for colorectal cancer (CRC) liver metastases. Twenty-four consecutive patients underwent liver resection using IOUS and CEIOUS for CRC liver metastases. CEIOUS was accomplished with intravenous injection of 4.8 mL of sulphur-hexafluoride microbubbles. CEIOUS found lesions missed at preoperative imaging and at IOUS in four patients and confirmed all of the new findings of IOUS in four patients. In addition, CEIOUS helped to define the tumor margins of the main lesion in 29% of patients with CRC liver metastases. No adverse effects were observed in relation with CEIOUS. In conclusion, CEIOUS improves IOUS accuracy with a significant impact on surgical strategy and radicality in patients who undergo surgery for CRC liver metastases.

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Authors and Affiliations

  1. Liver Surgery Section, Third Department of Surgery, Faculty of Medicine, University of Milan, Istituto Clinico Humanitas, IRCCS, Via Manzoni, 56, I-20089, Rozzano, Milan, Italy

    Guido Torzilli M.D., Ph.D., Daniele Del Fabbro M.D., Angela Palmisano M.D., Matteo Donadon M.D., Paolo Bianchi M.D. & Marco Montorsi M.D.

  2. Department of Pathology, Faculty of Medicine, University of Milan, Istituto Clinico Humanitas, IRCCS, Rozzano (Milano), Italy

    Massimo Roncalli M.D., Ph.D.

  3. Department of Radiology, Istituto Clinico Humanitas, IRCCS, Rozzano (Milano), Italy

    Luca Balzarini M.D.

Authors
  1. Guido Torzilli M.D., Ph.D.
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  2. Daniele Del Fabbro M.D.
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  3. Angela Palmisano M.D.
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  4. Matteo Donadon M.D.
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  5. Paolo Bianchi M.D.
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  6. Massimo Roncalli M.D., Ph.D.
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  7. Luca Balzarini M.D.
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  8. Marco Montorsi M.D.
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Correspondence to Guido Torzilli M.D., Ph.D..

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Torzilli, G., Fabbro, D.D., Palmisano, A. et al. Contrast-enhanced intraoperative ultrasonography during hepatectomies for colorectal cancer liver metastases. J Gastrointest Surg 9, 1148–1154 (2005). https://doi.org/10.1016/j.gassur.2005.08.016

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  • DOI: https://doi.org/10.1016/j.gassur.2005.08.016

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