{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:17:37Z","timestamp":1791181057526,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2011,9,30]],"date-time":"2011-09-30T00:00:00Z","timestamp":1317340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intraoperative detection of new nodules is common in patients undergoing hepatectomy for colorectal liver metastases, although the value of intraoperative diagnosis is not well assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospectively collected and recorded database was retrospectively analyzed. Helical computed tomography (CT) results were correlated with those of the intraoperative diagnosis in 183 consecutive patients undergoing 254 consecutive hepatectomies, including repeated resection for colorectal liver metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 270\u00a0nodules were newly detected during 65 hepatectomies. The sensitivity of CT to detect metastatic nodules was 72.8% (722\/992), but it decreased to 34.6% (125\/361) for small (\u22641\u00a0cm diameter) tumors. Intraoperative visual inspection and\/or palpation detected 207 of 270\u00a0nodules. Intraoperative ultrasonography (IOUS) played an important role in identifying deep (\u22651\u00a0cm from the surface) and comparatively small (\u22641\u00a0cm diameter) nodules (4\/9 vs. 16\/18, respectively, for those &gt;1\u00a0cm vs. \u22641\u00a0cm diameter). The likelihood of intraoperative detection of new nodules increased from 10\u00a0in 112 to 6\u00a0in 9 when the preoperative tumor number increased from solitary to \u226510, resulting in an overall likelihood of 65\u00a0in 254 (25.6%). Of 65 patients with new nodules, 21 had at least one nodule that was detected only by IOUS. Preoperatively scheduled hepatectomy was altered in 47 (72%) patients, although additional limited resection(s) were sufficient to remove these nodules in 43 (91%) of them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Visual inspection, palpation, and IOUS had equally indispensable roles in detecting new nodules during hepatectomy. Detection was common and usually necessitated alteration, albeit moderately, of the surgical plan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-011-1264-7","type":"journal-article","created":{"date-parts":[[2011,9,29]],"date-time":"2011-09-29T11:52:14Z","timestamp":1317297134000},"page":"2779-2787","source":"Crossref","is-referenced-by-count":43,"title":["Value of Visual Inspection, Bimanual Palpation, and Intraoperative Ultrasonography During Hepatic Resection for Liver Metastases of Colorectal Carcinoma"],"prefix":"10.1002","volume":"35","author":[{"given":"Shojiro","family":"Hata","sequence":"first","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplantation Surgery, Department of Surgery, Graduate School of Medicine University of Tokyo 7\u20103\u20101\u2010 Hongo, Bunkyo\u2010ku 113\u20100033 Tokyo 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