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

Hariharan, Deepak; Constantinides, Vasilis; Kocher, Hemant M.; Tekkis, Paris P.

doi:10.1016/j.amjsurg.2011.07.018

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

Deepak Hariharan, M.R.C.S., M.D. (Research)
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
- Department of Surgery, Queens Medical Centre, Nottingham, UK
Vasilis Constantinides, M.R.C.S., M.D.
- Academic Surgical Unit, Imperial College, Chelsea and Westminster Hospital, London, UK
Hemant M. Kocher, F.R.C.S., M.D.
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
- Barts and the London HepatoPancreatoBiliary Centre, The Royal London Hospital, London, UK
- Corresponding author. Tel.: +44 (0) 20-78823579; fax: +44 (0) 20-78823884
Paris P. Tekkis, F.R.C.S., M.D.
- Academic Surgical Unit, Imperial College, Chelsea and Westminster Hospital, London, UK

Received 22 October 2010; received in revised form 6 July 2011 published online 16 January 2012.
Corrected Proof

Abstract

Background

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

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.

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.