The value of contrast-enhanced laparoscopic ultrasound during robotic-assisted surgery for primary colorectal cancer

J Clin Ultrasound. 2018 Mar;46(3):178-182. doi: 10.1002/jcu.22560. Epub 2017 Nov 13.

Abstract

Aim: 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).

Method: 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.

Results: 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.

Conclusion: 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.

Keywords: colorectal cancer; contrast-enhanced laparoscopic ultrasound; intraoperative ultrasound; liver metastasis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colon / diagnostic imaging
  • Colon / surgery
  • Colorectal Neoplasms / diagnostic imaging*
  • Colorectal Neoplasms / surgery*
  • Contrast Media*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Image Enhancement / methods*
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Prospective Studies
  • Rectum / diagnostic imaging
  • Rectum / surgery
  • Robotic Surgical Procedures / methods*
  • Ultrasonography / methods*

Substances

  • Contrast Media