Ellebaek Signe Bremholm, Fristrup Claus Wilki, Pless Torsten, Poornoroozy Peiman Hossein, Andersen Per Vadgaard, Mahdi Bassam, Mortensen Michael Bau
Department of Surgery, Odense University Hospital, Odense C, Denmark.
Department of Radiology, Odense University Hospital, Odense C, Denmark.
J Clin Ultrasound. 2018 Mar;46(3):178-182. doi: 10.1002/jcu.22560. Epub 2017 Nov 13.
The aim of this study was to assess the potential clinical value of contrast enhanced laparoscopic ultrasonography (CE-LUS) as a screening modality for liver metastases during robotic assisted surgery for primary colorectal cancer (CRC).
A prospective, descriptive (feasibility) study including 50 consecutive patients scheduled for robotic assisted surgery for primary CRC. CE-LUS was performed by 2 experienced specialists. Only patients without metastatic disease were included. Follow-up was obtained with contrast-enhanced CT imaging at 3 and 12 months postoperatively.
Fifty patients were included; 45 patients were available for final analysis. The patients were equally distributed between stage I, II, and III according to the TNM classification system. No liver metastasis was detected during LUS and CE-LUS. CE-LUS was easy to perform and there was no complication. Follow-up revealed no liver metastasis in any of the patients.
CE-LUS did not increase the detection rate of occult liver metastasis during robotic assisted primary CRC surgery. The use of CE-LUS as a screening modality for detection of liver metastasis cannot be recommended based on this study, but larger controlled studies on high-risk patients seem relevant.
本研究旨在评估在原发性结直肠癌（CRC）机器人辅助手术期间，对比增强腹腔镜超声检查（CE-LUS）作为肝转移筛查方式的潜在临床价值。
一项前瞻性、描述性（可行性）研究，纳入50例计划接受原发性CRC机器人辅助手术的连续患者。CE-LUS由2名经验丰富的专家进行操作。仅纳入无转移性疾病的患者。术后3个月和12个月通过对比增强CT成像进行随访。
纳入50例患者；45例患者可进行最终分析。根据TNM分类系统，患者在I期、II期和III期之间均匀分布。在腹腔镜超声检查（LUS）和CE-LUS期间未检测到肝转移。CE-LUS操作简便，且无并发症。随访显示所有患者均未发生肝转移。
在机器人辅助原发性CRC手术期间，CE-LUS并未提高隐匿性肝转移的检出率。基于本研究，不推荐将CE-LUS用作检测肝转移的筛查方式，但对高危患者进行更大规模的对照研究似乎是有必要的。
