The role of laparoscopy and laparoscopic ultrasound in the preoperative staging of patients with resectable colorectal liver metastases: a meta-analysis

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• 作者：Deepak Hariharan ; M.R.C.S. ; M.D. (Research)^a ; ^b ; Vasilis Constantinides ; M.R.C.S. ; M.D.^c ; Hemant M. Kocher ; F.R.C.S. ; M.D.^a ; ^d ; ^{h.kocher@qmul.ac.uk} ; Paris P. Tekkis ; F.R.C.S. ; M.D.^c
• 关键词：Colorectal liver metastasis ; Laparoscopy ; Meta-analysis ; Peritoneal metastases ; Diagnostic accuracy
• 刊名：The American Journal of Surgery
• 出版年：2012
• 期刊代码：9_00029610
• 类别：med
• 出版时间：July, 2012
• 卷：204
• 期：1
• 页码：84-92
• 文件大小：1372 K

摘要

ass="h4">Background

The role of staging laparoscopy (SL) with laparoscopic ultrasound (LUS) in patients with resectable colorectal liver metastases (CRLM) remains controversial.

ass="h4">Methods

A meta-analysis of all studies (from 1998 to the present) on the effect of SL/LUS in patients with potentially resectable CRLM with respect to alteration in surgical management was performed.

ass="h4">Results

Twelve studies satisfied the inclusion criteria. A total of 1,047 patients underwent SL/LUS. The true yield of SL/LUS for CRLM was 19%(95%confidence interval [CI], 16%-22%), with a diagnostic odds ratio of 132 (95%CI, 56-310) and an overall sensitivity of 59%(95%CI, 53%-65%). Subgroup analysis for detection of other liver and peritoneal lesions showed a sensitivity of 59%(95%CI, 49%-67%) and 75%(95%CI, 63%-85%) respectively. There was major between-study heterogeneity for all analyses, with no obvious cause revealed by meta-regression.

ass="h4">Conclusions

The true benefit of using SL/LUS universally seems limited. It appears more useful as an adjunct in patients when peritoneal disease is suspected.