Contrast-Enhanced Intraoperative Ultrasonography During Hepatectomies for Colorectal Cancer Liver Metastases

The Aim of Technology During Liver Resection — A Strategy to Minimize Blood Loss During Liver Surgery

“…This finding, combined with a contrast-enhanced IOUS during the resection, could be a rationale incentive for practising limited resections [108][109][110], and the possibility of an accurate investigation of the remnant liver through the IOUS Drug administration for reducing intra-operative blood loss: Liver resection may cause a variable degree of hyperfibrinolytic states; this phenomenon occurs in the days immediately after hepatectomy and is more pronounced in patients with a diseased liver or in patients who have undergone to a wider hepatectomy extent [111][112][113][114][115][116]So some authors propose the utilization of drugs with antifibrinolytic effect like Aprotinin that is reported to be capable to reduce intra-operative blood loss (especially during liver resection time) and transfusions [117][118][119]. Other authors propose utilization of the cheaper Tranexamic acid reporting similar results [120].…”

Ultrasound Examination in Detection and Characterization of Colorectal Liver Metastases

“…Recent studies of intraoperative contrast-enhanced ultrasound (IO-CEUS) with different contrast agents have shown that it is more sensitive, specific and accurate than IOUS, CT or MRI in detecting and defining whether tumor resection is appropriate [61][62][63] (Figure 6). …”

Colorectal Liver Metastasis: Current Management

“…Laparoscopy, which is not routinely used in the pre-operative evaluation of the advanced disease, allows an assessment of the peritoneal and pelvic spread of the primitive cancer and, with the combined use of laparoscopic ultrasound (LIOUS), enables detection of small metastases, varying the initial surgical plan in 20-30% of the cases (Guglielmi et al 2005). Contrast enhanced IOUS (CE-IOUS) shows some benefit over pre-operative imaging and IOUS since it seems to improve the ability to characterize already detected lesions and facilitate the detection of new metastatic lesions (Fioole et al 2008;Leen et al 2006;Nakano et al 2008;Torzilli et al 2005). …”