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Eur J Surg Oncol. 2013 Jul;39(7):721-5. doi: 10.1016/j.ejso.2013.03.024. Epub 2013 Apr 22.

Routine staging laparoscopy has no place in the management of colorectal liver metastases.

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1
Northwestern Hepatobiliary Unit, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, United Kingdom. ddunne@nhs.net

Abstract

AIMS:

Staging laparoscopy has been recommended in the management of patients with colorectal liver metastases prior to hepatectomy in order to reduce the incidence and associated morbidity of futile laparotomies. The utility of staging laparoscopy has not been assessed in patients undergoing CT, PET-CT and MRI as standard preoperative staging.

METHODS:

All patients undergoing attempted open hepatectomy for colorectal liver metastases between 1/4/2008 and 31/3/2012 were identified from a prospectively maintained research database. All patients who underwent futile laparotomy were identified, with demographics and operative notes subsequently analysed.

RESULTS:

A total of 274 patients underwent attempted open hepatectomy during the study period. At laparotomy 12 (4.4%) patients were found to have irresectable disease. There were no unifying demographic factors within the patients undergoing futile laparotomy.

CONCLUSIONS:

With modern imaging, the potential yield of staging laparoscopy is low. Staging laparoscopy should not be used routinely, but may have a role in the case of specific clinical concerns.

PMID:
23618549
DOI:
10.1016/j.ejso.2013.03.024
[Indexed for MEDLINE]
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