Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/10278
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Type: Journal article
Title: The value of laparoscopic staging for patients with colorectal metastases
Author: Metcalfe, M.
Close, J.
Iswariah, H.
Morrison, C.
Wemyss-Holden, S.
Maddern, G.
Citation: Archives of Surgery, 2003; 138(7):770-772
Publisher: Amer Medical Assoc
Issue Date: 2003
ISSN: 0004-0010
1538-3644
Statement of
Responsibility: 
Matthew S. Metcalfe, John S. Close, Harish Iswariah, Charles Morrison, Simon A. Wemyss-Holden and Guy J. Maddern
Abstract: Background: Resection offers the only chance of cure for hepatic colorectal metastases. However, preoperative staging does not always reliably detect unresectable disease. The aim of this study was to investigate the role that laparoscopy with ultrasound may have in detecting unresectable disease, thus sparing patients from unnecessary laparotomy with the associated morbidity and cost. Methods: A retrospective review of all patients considered for liver resection of colorectal metastases during a 3-year period was performed, analyzing factors likely to predict resectable disease, rates of resectability, and success of laparoscopic staging at detecting unresectable disease. Results: Of 73 patients with resectable disease on computed tomography, 24 were deemed to need laparoscopy, and 49 proceeded directly to laparotomy. Those first undergoing laparoscopy had shorter disease-free intervals between diagnosis of colorectal cancer and detection of hepatic recurrence and greater numbers of hepatic metastases. Twelve of the 24 patients who underwent laparoscopy had unresectable disease, and 8 of these were detected at laparoscopy. Forty-six of the 49 patients proceeding to laparotomy directly had resectable disease. Conclusions: Laparoscopic staging of hepatic colorectal metastatic disease detects most unresectable disease, preventing unnecessary laparotomy. The likelihood of disease being unresectable is in part predicted by the disease-free interval and the number of hepatic metast
Keywords: Humans; Colorectal Neoplasms; Liver Neoplasms; Laparoscopy; Neoplasm Staging; Risk Factors; Retrospective Studies; Predictive Value of Tests; Female; Male
Description: © American Medical Association
RMID: 0020030124
DOI: 10.1001/archsurg.138.7.770
Published version: http://archsurg.ama-assn.org/cgi/content/full/138/7/770
Appears in Collections:Surgery publications

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