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Intraoperative Sonographie zum Nachweis occulter Lebermetastasen beim colorectalen Carcinom

Intraoperative ultrasonography for the detection of occult liver metastases in colorectal cancer

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Summary

In a prospective study of 85 patients with operation of colorectal cancer intraoperative ultrasonography of the liver was performed for the detection of liver metastases. The findings were compared with the results of preoperative ultrasonography and CT-scan as well as the findings of intraoperative inspection and palpation of the liver. Seventeen (24.3%) of a total of 70 metastases of this series could only be detected by intraoperative ultrasonography. This was related to 12 (14.1 %) of the examined patients. Four (5.7%) of these lesions were solitary and concerned 4.7% of the cases. Due to the intraoperative sonographic findings the tactics of operation was changed in 15.3% of the patients. Intraoperative ultrasonography has a significantly higher sensitivity for the detection of liver metastases from colorectal cancer than preoperative ultrasonography and computed tomography or intraoperative inspection and palpation. Intraoperative ultrasonography of the liver should be applied in all patients without preoperative evidence of liver metastases and in patients with a planned resection of metastases.

Zusammenfassung

In einer prospektiven Studie wurde bei 85 Patienten mit Operation colorectaler Carcinome eine intraoperative Sonographie der Leber zum Nachweis von Lebermetastasen durchgeführt. Die Befunde wurden verglichen mit den Ergebnissen der präoperativ vorgenommenen Sonographie und Computertomographie sowie der intraoperativen Inspektion und Palpation der Leber. Siebzehn (24,3%) der insgesamt 70 Metastasen dieser Untersuchungsserie konnten allein durch die intraoperative Sonographie nachgewiesen werden. Dieses betraf 12 (14,1%) der untersuchten Patienten. Vier (5,7%) dieser Herde waren solitär und betrafen 4,7% der Fälle. In 15,3% der Patienten wurde aufgrund der intraoperativen Ultraschallbefunde die Operationstaktik geändert. Beim Nachweis von Lebermetastasen colorectaler Carcinome hat die intraoperative Sonographie eine signifikant höhere Sensitivität als die präoperative Sonographie und Computertomographie bzw. die intraoperative Inspektion und Palpation. Die intraoperative Ultraschalluntersuchung sollte bei allen Patienten ohne präoperativen Nachweis von Lebermetastasen und bei Patienten mit geplanter Metastasenresektion durchgeführt werden.

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  1. Chirurgische Klinik und Poliklinik der Technischen Universität München Klinikum rechts der Isar, Ismaninger Straße 22, D-8000, München 80, Germany

    A. H. Hölscher & J. Stadler

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  1. A. H. Hölscher
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  2. J. Stadler
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Hölscher, A.H., Stadler, J. Intraoperative Sonographie zum Nachweis occulter Lebermetastasen beim colorectalen Carcinom. Langenbecks Arch Chiv 374, 363–369 (1989). https://doi.org/10.1007/BF01262816

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  • DOI: https://doi.org/10.1007/BF01262816

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