Stereotactic excision of additional lesions detected with intraoperative ultrasound examination during radiofrequency dissecting sealar (habib®) assisted hepatic metastasectomy: report of 4 cases.
← Research streamAmong 58 CLM resections, 4 patients required stereotactic metastasectomy for nonpalpable lesions; intraoperative ultrasound detected an additional lesion in one case. All lesions resected (conventional and stereotactic) had negative margins; pathology include…
Study snapshot
Abstract
Intraoperative ultrasound has been using to achieve a proper resection strategy in patients undergoing a hepatic colorectal metastasectomy. This study aims to describe and reveal the place of stereotactic metastasectomy in nonpalpable colorectal liver metastases (CLM). A chart review was initiated for all patients underwent resection for CLM between 2006 and 2011. The data concerning perioperative data and intraoperative strategy were abstracted. Among the 58 patients, who underwent a resection for CLM, 4 (6.9 %) (all men, median age 65.5, range 49-72, years) necessitated a stereotactic metastasectomy. Preoperative evaluations showed 1 (n = 1), 2 (n = 2), or 3 (n = 1) lesions, and intraoperative ultrasound (IUS) found an additional lesion in a case. Stereotactic marking was performed for nonpalpable lesions located in segments IVA, II, and VI and at the junction of segments V and VI. The margins were negative for all lesions both resected with conventional and stereotactic techniques. The examinations of the stereotactic resection materials revealed metastatic adenocarcinoma (patients n = 2), focal nodular hyperplasia (n = 1), and abnormal benign liver histology probably induced by chemotherapy (n = 1). The median (range) operation and hospitalization periods were 217.5 (150-310) minutes and 5.5 (2-9) days. No complications were observed except biliary fistula in a case, which spontaneously disappeared within 2 weeks. A patient died due to systemic disease including hepatic metastases 33 months after the liver surgery. Stereotactic metastasectomy may be feasible for the removal of nonpalpable CLM. Further evaluations are necessitated to understand the accurate place of this novel technique.
AI evidence extraction
Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.
Main findings
Among 58 CLM resections, 4 patients required stereotactic metastasectomy for nonpalpable lesions; intraoperative ultrasound detected an additional lesion in one case. All lesions resected (conventional and stereotactic) had negative margins; pathology included metastatic adenocarcinoma (n=2), focal nodular hyperplasia (n=1), and abnormal benign liver histology probably induced by chemotherapy (n=1). Median operation time was 217.5 minutes and median hospitalization was 5.5 days; one biliary fistula resolved spontaneously, and one patient died 33 months later due to systemic disease including hepatic metastases.
Outcomes measured
- Feasibility of stereotactic metastasectomy for nonpalpable CLM
- Resection margin status (negative margins)
- Histopathology of resected lesions
- Operative time
- Hospital length of stay
- Perioperative complications
- Mortality/follow-up outcome
Limitations
- Case series of 4 patients (very small sample)
- Retrospective chart review design
- No control/comparator group
- Outcomes focused on surgical feasibility rather than EMF exposure effects; no RF exposure parameters reported
View raw extracted JSON
{
"study_type": "case_report",
"exposure": {
"band": null,
"source": "radiofrequency dissecting sealar (Habib®) assisted hepatic metastasectomy",
"frequency_mhz": null,
"sar_wkg": null,
"duration": null
},
"population": "Patients undergoing resection for colorectal liver metastases (CLM); 4 cases requiring stereotactic metastasectomy (all men; median age 65.5 years, range 49–72)",
"sample_size": 4,
"outcomes": [
"Feasibility of stereotactic metastasectomy for nonpalpable CLM",
"Resection margin status (negative margins)",
"Histopathology of resected lesions",
"Operative time",
"Hospital length of stay",
"Perioperative complications",
"Mortality/follow-up outcome"
],
"main_findings": "Among 58 CLM resections, 4 patients required stereotactic metastasectomy for nonpalpable lesions; intraoperative ultrasound detected an additional lesion in one case. All lesions resected (conventional and stereotactic) had negative margins; pathology included metastatic adenocarcinoma (n=2), focal nodular hyperplasia (n=1), and abnormal benign liver histology probably induced by chemotherapy (n=1). Median operation time was 217.5 minutes and median hospitalization was 5.5 days; one biliary fistula resolved spontaneously, and one patient died 33 months later due to systemic disease including hepatic metastases.",
"effect_direction": "unclear",
"limitations": [
"Case series of 4 patients (very small sample)",
"Retrospective chart review design",
"No control/comparator group",
"Outcomes focused on surgical feasibility rather than EMF exposure effects; no RF exposure parameters reported"
],
"evidence_strength": "very_low",
"confidence": 0.74,
"peer_reviewed_likely": "yes",
"keywords": [
"intraoperative ultrasound",
"stereotactic metastasectomy",
"colorectal liver metastases",
"hepatic metastasectomy",
"radiofrequency dissecting sealar",
"Habib"
],
"suggested_hubs": []
}AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.
Identifiers and source
DOI: 10.1007/s12262-012-0554-0
PubMed: 24799786