دورية أكاديمية
Diagnostic laparoscopy for primary and secondary liver malignancies: impact of improved imaging and changed criteria for resection.
| العنوان: | Diagnostic laparoscopy for primary and secondary liver malignancies: impact of improved imaging and changed criteria for resection. |
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| المؤلفون: | de Castro SM; Academic Medical Center, Department of Surgery, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands., Tilleman EH, Busch OR, van Delden OM, Laméris JS, van Gulik TM, Obertop H, Gouma DJ |
| المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2004 May; Vol. 11 (5), pp. 522-9. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print Cited Medium: Print ISSN: 1068-9265 (Print) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Original Publication: New York, NY : Raven Press, c1994- |
| مواضيع طبية MeSH: | Endosonography* , Laparoscopy*, Carcinoma, Hepatocellular/*diagnostic imaging , Liver Neoplasms/*diagnostic imaging , Neoplasm Staging/*methods, Aged ; Carcinoma, Hepatocellular/secondary ; Carcinoma, Hepatocellular/surgery ; Colorectal Neoplasms/pathology ; Diagnosis, Differential ; Female ; Humans ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Tissue Adhesions ; Tomography, Spiral Computed |
| مستخلص: | 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. |
| تواريخ الأحداث: | Date Created: 20040505 Date Completed: 20040803 Latest Revision: 20161124 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1245/ASO.2004.09.009 |
| PMID: | 15123462 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1068-9265 |
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| DOI: | 10.1245/ASO.2004.09.009 |