[Preoperative staging on liver metastasis from colorectal carcinoma]

Preoperative staging of metastatic liver cancer (MLC) from colorectal carcinoma (CRC) is conducted with the purpose to identify potentially resectable MLC cases. Fifty-two patients undergo laparoscopic study (4.1% all endoscopies), and three--laparoscopic ultrasonography. Laparoscope E Wolf and 7.5 MHz linear transducer obtained from the Aloka Company are employed. The study covers 24 women and 28 men with mean age 61.6 years (range 23-87 y). MLC is diagnosed in 35.1% (13/37) of colonic, and in 73.3% (11/15) of rectal carcinoma cases. Furthermore, 69.3% of the patients (36/52) are in M-stage, accounted for by peritoneal or hepatic metastases. The size of lesions measures less than 2 cm in 25.0%, and less than 1 cm in 12.5% of the cases. Solitary metastasis is recorded in 8.3 per cent. In the event of isolated involvement of the left lobe the location of MLC is in the region of II-III segment. In one patient a single metastasis in VII segment, measuring 0.5/1.0 cm, missed by the imaging methods and laparoscopy, is documented by laparoscopic ultrasonography. Echographic diagnosis proves inaccurate in 16.7%, and false negative--in 12.5 per cent. In further three patients (12.5%) the conclusion reached is uncertain, with primary liver cancer being also considered. In 23.1% MLC from colonic carcinoma is situated entirely intrahepatally, and is not accessible to endoscopic inspection without laparoscopic and/or intraoperative ultrasonography; the latter is indicated in all T3 and T4 patients. Potential resectability is established in 16.7% of cases with liver metastases from CRC.