Randomized clinical trial of laparoscopic ultrasonography before laparoscopic colorectal cancer resection. BJS 2017; 104: 1462-1469.
Published: 12th September 2017
Authors: S. B. Ellebæk, C. W. Fristrup, C. Hovendal, N. Qvist, L. Bundgaard, S. Salomon et al.
Intraoperative ultrasonography during open surgery for colorectal cancer may be useful for the detection of unrecognized liver metastases. Laparoscopic ultrasonography (LUS) for the detection of unrecognized liver metastasis has not been studied in a randomized trial. This RCT tested the hypothesis that LUS would change the TNM stage and treatment strategy.
Patients with colorectal cancer and no known metastases were randomized (1 : 1) to laparoscopic examination (control or laparoscopy plus LUS) in three Danish centres. Neither participants nor staff were blinded to the group assignment.
Three hundred patients were randomized, 150 in each group. After randomization, 43 patients were excluded, leaving 128 in the control group and 129 in the LUS group. Intraoperative T and N categories were not altered by LUS, but laparoscopy alone identified previously undetected M1 disease in one patient (0·8 per cent) in the control group and three (2·3 per cent) in the LUS group. In the latter group, LUS suggested that an additional six patients (4·7 per cent) had M1 disease with liver (4) or para‐aortal lymph node (2) metastases. The change in treatment strategy was greater in the LUS than in the control group (7·8 (95 per cent c.i. 3·8 to 13·8) and 0·8 (0 to 4·2) per cent respectively;
Routine LUS during resection of colorectal cancer is not recommended. Registration number: NCT02079389 (
You may also be interested in
Meta‐analysis of in‐hospital delay before surgery as a risk factor for complications in patients with acute appendicitis. BJS 2018; 105: 933-945.
Authors: S. T. van Dijk, A. H. van Dijk, M. G. Dijkgraaf, M. A. Boermeester
Notes: Delay is safe
Magnetic resonance tumour regression grade and pathological correlates in patients with rectal cancer.
Authors: J. K. Jang, J. L. Lee, S. H. Park, H. J. Park, I. J. Park, J. H. Kim et al.
Neoadjuvant chemotherapy response influences outcomes in non‐colorectal, non‐neuroendocrine liver metastases.
Authors: A. M. Lucchese, A. N. Kalil, A. Ruiz, V. Karam, O. Ciacio, G. Pittau et al.
Notes: Multimodal therapy works
Long‐term prognostic impact of surgical complications in the German Rectal Cancer Trial CAO/ARO/AIO‐94.
Authors: T. Sprenger, T. Beißbarth, R. Sauer, J. Tschmelitsch, R. Fietkau, T. Liersch et al.
Notes: Morbidity matters
Authors: B. Groot Koerkamp, W. R. Jarnagin
Oncological outcome after MRI‐based selection for neoadjuvant chemoradiotherapy in the OCUM Rectal Cancer Trial.
Authors: R. Ruppert, T. Junginger, H. Ptok, J. Strassburg, C. A. Maurer, P. Brosi et al.
Notes: Limiting radiotherapy appears safe.
Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection.
Authors: M. C. Halls, G. Berardi, F. Cipriani, L. Barkhatov, P. Lainas, S. Harris et al.
Notes: Helps improve selection for laparoscopic liver resection
Validation of at least 1 mm as cut‐off for resection margins for pancreatic adenocarcinoma of the body and tail.
Authors: T. Hank, U. Hinz, I. Tarantino, J. Kaiser, W. Niesen, F. Bergmann et al.
Notes: Validating 1mm for R0
Meta‐analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer. BJS 2018; 105: 946-958.
Authors: E. Versteijne, J. A. Vogel, M. G. Besselink, O. R. C. Busch, J. W. Wilmink, J. G. Daams et al.
Notes: Improved survival with neoadjuvant treatment
Authors: G. A. Margonis, K. Sasaki, S. Gholami, Y. Kim, N. Andreatos, N. Rezaee et al.
Notes: Predicts survival
Reappraisal of classification of distal cholangiocarcinoma based on tumour depth. BJS 2018; 105: 867-875.
Authors: H. Aoyama, T. Ebata, M. Hattori, M. Takano, H. Yamamoto, M. Inoue et al.
Notes: Better for T staging
Randomized clinical trial
Randomized clinical trial of elective resection versus observation in diverticulitis with extraluminal air or abscess initially managed conservatively. BJS 2018; 105: 971-979.
Authors: K. You, R. Bendl, C. Taut, R. Sullivan, M. Gachabayov, R. Bergamaschi et al.
Notes: Conservative management appropriate