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1

The Value of Intraoperative Liver Ultrasound Assessment Using an Intraabdominal Probe During Laparotomy Performed for Oncological Reasons

100%

Kruszewski W. J., Walczak J., Szajewski M., Buczek T., Ciesielski M., Szefel J.

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vol. 85

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issue 2

78-82

EN

The quality of liver assessment in an oncological patient plays an important role in the selection of a proper type of medical intervention. Diagnostic techniques commonly used in liver imaging are still far from perfect. Intraoperative liver evaluation using an intraabdominal ultrasound probe remains an important tool for proper assessment of this organ. The aim of the study was to evaluate suitability of this intraoperative diagnostic method for detection of primary and secondary neoplastic pathologies of the liver. Material and methods. Between March 2010 and the end of December 2011, we performed intraoperative ultrasound examinations of the liver during 220 of 461 laparotomies carried out for oncological reasons. Results. In 72 patients (33%), intraoperative ultrasonography using an intraabdominal probe revealed neoplastic pathologies in the liver. In 16 patients (7%), the pathologies had not been observed in the preoperative imaging examinations. In 7 cases (3%), the detected tumors were impalpable and invisible in macroscopic examination routinely performed during laparotomy. The time of performing preoperative liver examinations did not affect the detection of previously unrecognized liver tumors (p > 0.05). We found progression in the number of liver tumors in 28 patients (39%). In 20 patients (9%), the primary surgical plans were changed intraoperatively. Conclusions. Liver examination using an intraabdominal ultrasound probe is a useful tool for assessment of neoplastic disease progression. The procedure allows proper choice of an optimal treatment regime and decreases the risk of performing an unnecessary oncological invasive procedure.

2

Navigation with Use of Intra-Operative Ultrasound in Search for Neoplastic Lesions of Endocrine Glands

80%

Sopiński J., Kuzdak K.

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vol. 85

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issue 5

262-270

EN

was to evaluate the effectiveness of intraoperative ultrasonography (IOUS) during operations of endocrine glands tumors. Material and methods. The study was conducted in patients who underwent endocrine operation in Department of Endocrine, General and Vascular Surgery, Medical University in Łódź in 2008-2011. Results. Patients with thyroid cancer recurrences:in study group we managed shorter lesion access time (10 ± 4.47 min vs 16.78 ± 8.9 min; p=0.04). Time of surgery was also shorter in study group (75 ± 30.17 minvs 85,71 ± 38.92 min), but it was not significant (p=0.46). The use of IOUS did not affect the hospitalization time (2.91 ± 1.64 days vs 3 ± 1.66 days; p=0.820), intraoperative blood loss (45.45 ± 105.96 ml vs 40 ± 82.89 ml; p=0.972) and the rate of intraoperative complications (1/11 - 9.09% vs 2/14 - 14.29%; p=1). Patients with primary hyperparathyroidism: the time of surgery (58± 22.74 min vs 65 ± 19.6 min; p=0.336) and the lesion access time (13.33 ± 7,94 min vs 17.25 ± 8.19 min; p=0.169) were shorter in study group. Hospitalization time was longer in study group (6.13 ± 5.3 days vs 4.45 ± 4.58 days; p=0.079). The rate of intraoperative complications was higher in study group (3/15 - 20% vs 2/20 - 10%; p=0.631). None of this results were statistically significant (p≤0.05). Patients who underwent open adrenalectomy: in study group we managed significantly shorter time of surgery (70 ± 44.35 min vs 80.12 ± 29.60 min; p=0.033) and shorter lesion access time (12 ± 8.88 min vs 17.37 ± 7.42 min; p=0.045). The use of IOUS did not affect the hospitalization time (5.6 ± 1.65 days vs 6.35 ± 2.38 days; p=0.429), intraoperative blood loss (110 ± 164.65 ml vs 172.5 ± 226.35 ml; p=0.442) and rate of intraoperative complications (0/10 vs 1/40; p=1). Patients who underwent videoscopicadrenalectomy: in study group we managed to get shortertime of surgery (89.44 ± 27.11 min vs 109.12 ± 33.88 min; p=0.034) and shorter lesion access time (28.61 ± 14.93 min vs 45.98 ± 20.44 min; p=0.002). Intraoperative blood loss was also significantly lower in study group (86.11 ± 157 ml vs 169.27 ± 201.04 ml; p=0.037). The use of IOUS did not affect the hospitalization time (4.39 ± 3.27 days vs 3.83 ± 3.67 days; p=0.227), the rate of intraoperative complications (0/18 vs. 2/41; p=1) and the conversion rate (2/20-10% vs. 5/46- 10.87%; p=1). Conclusions. 1.During adrenalectomies this technique facilitates finding the pathological lesion shortening the time of access to the tumor and procedure duration. 2. IOUS is useful for determining the tumor relationship with the surrounding anatomical structures. 3. IOUS isa useful technique in the assessment of adrenal tumor infiltration of vena cava. 4. The use of IOUS allows the surgeon to assess anatomical relationships in the real time, after incision and retraction of tissues. 5. During operations of thyroid cancer recurrences using this technique makes easier to find a lesion in the operated area and it is possible to asses radical of surgery. 6. The use of IOUS allows to find pathological parathyroid glands inside thyroid gland. 7. IOUS is useful in the detection of thyroid pathology during parathyroidectomy.

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Znaczenie ultrasonografi i śródoperacyjnej w rozpoznaniu rzekomego obrzęku rdzenia kręgowego

51%

Saxena A., Rao G., Ivanov M.

Journal of Ultrasonography

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2014

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vol. 14

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issue 56

89-93

EN

We present the case of a woman who presented with weakness of both legs due to a low grade tumor of the spinal cord. Excision of the tumor was performed and confi rmed with intraoperative ultrasound. Prior to dural closure the spinal cord was found to be pushed dorsally with herniation of the cord through the dural defect. Intraoperative ultrasound showed a collection of cerebrospinal fl uid in an anterior pocket giving the impression of the cord being swollen. Once cerebrospinal fl uid was drained, the cord settled within the thecal space and closure of the dural defect was performed. Surgery for an intramedullary spinal cord tumor can cause a signifi cant amount of swelling and either a duroplasty is required or the dura is left open with meticulous closure of the wound. Ultrasound is helpful to identify pathology anterior to the cord and prevents the potential complications associated with duroplasty or leaving the dura open.

PL

Przedstawiamy przypadek pacjentki, która zgłosiła się z niedowładem kończyn dolnych w przebiegu dobrze zróżnicowanego guza rdzenia kręgowego. Guz usunięto, co zostało potwierdzone w śródoperacyjnym badaniu ultrasonografi cznym. Przed zamknięciem opony twardej stwierdzono przemieszczenie się części operowanej rdzenia kręgowego w obrębie ubytku opony. Śródoperacyjne badanie ultrasonografi czne wykazało odcinkowe nagromadzenie płynu mózgowo-rdzeniowego na przedniej powierzchni rdzenia kręgowego, co imitowało jego obrzęk. Wykonanie drenażu gromadzącego się płynu mózgowo-rdzeniowego umożliwiło zamknięcie ubytku opony twardej bez potrzeby wykonywania plastyki. Leczenie operacyjne guzów śródrdzeniowych może powodować istotny obrzęk. W takim przypadku wykonuje się plastykę opony twardej albo odstępuje się od jej zszywania. Badanie ultrasonografi czne jest pomocne w ocenie zmian zlokalizowanych poza możliwością kontroli wzrokowej i może zapobiec powikłaniom związanym z plastyką opony twardej lub pozostawieniem jej otwartej.

Refine search results

2 Polish Journal of Surgery

1 Journal of Ultrasonography

1 2014

2 2013

1 Buczek T.

1 Ciesielski M.

1 Ivanov M.

1 Kruszewski W. J.

1 Kuzdak K.

1 Rao G.

1 Saxena A.

1 Sopiński J.

1 Szajewski M.

1 Szefel J.

1 Walczak J.

The Value of Intraoperative Liver Ultrasound Assessment Using an Intraabdominal Probe During Laparotomy Performed for Oncological Reasons

Navigation with Use of Intra-Operative Ultrasound in Search for Neoplastic Lesions of Endocrine Glands

Znaczenie ultrasonografi i śródoperacyjnej w rozpoznaniu rzekomego obrzęku rdzenia kręgowego