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Diagnostic Laparoscopy for Primary and Secondary Liver Malignancies: Impact of Improved Imaging and Changed Criteria for Resection
- Source :
- Annals of surgical oncology, 11(5), 522-529. Springer New York
- Publication Year :
- 2004
- Publisher :
- Springer Science and Business Media LLC, 2004.
-
Abstract
- Background: Diagnostic laparoscopy (DL) combined with laparoscopic ultrasonography (LUS) has previously shown positive results as a staging modality for liver malignancies. Recent improvements in noninvasive diagnostic imaging techniques such as multiphasic spiral computed tomography, together with the policy that bilobar disease or the number of lesions is no longer considered an absolute exclusion criterion for curative resection, could reduce the additional value of DL. This study retrospectively analyzed the efficacy of DL combined with LUS for liver malignancies to assess the effect of improved imaging and changed criteria for resection. Methods: All patients with primary or metachronous secondary liver malignancy eligible for resection in 1997 to 2002 were included. Results: DL combined with LUS was performed in 84 consecutive patients (56 men and 28 women; mean age, 59 years) with primary (n = 33) or secondary (n = 51) liver malignancies. DL showed unresectability in 13 patients (39%) with primary malignancy. Exploratory laparotomy showed that an additional 5 (25%) of the remaining 20 patients had unresectable disease. DL showed unresectability in 5 patients (12%) with colorectal liver metastasis (n = 43). At laparotomy, another 7 (18%) of the remaining 38 patients had unresectable disease. In five patients (13%) from the latter group, LUS could not be performed because of adhesions from previous surgery. Conclusions: DL combined with LUS is an adequate staging modality for primary liver malignancies. For colorectal liver metastasis, more liberal resection criteria, a high failure rate due to adhesions from previous surgery, and better preoperative imaging probably resulted in a lower efficacy
- Subjects :
- Male
medicine.medical_specialty
Carcinoma, Hepatocellular
Tissue Adhesions
Diagnostic laparoscopy
Sensitivity and Specificity
Endosonography
Resection
Diagnosis, Differential
Surgical oncology
Medical imaging
Humans
Medicine
Laparoscopy
Aged
Neoplasm Staging
Retrospective Studies
Cancer staging
medicine.diagnostic_test
business.industry
Liver Neoplasms
Middle Aged
Prognosis
medicine.disease
Spiral computed tomography
Oncology
Hepatocellular carcinoma
Female
Surgery
Radiology
Colorectal Neoplasms
business
Tomography, Spiral Computed
Subjects
Details
- ISSN :
- 15344681 and 10689265
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Annals of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....7c2afb7ac7ca9e4d0f0e2c5521c32f8e