Advances in the surgical treatment of colorectal cancer liver metastases through ultrasound.

Surgery remains the gold standard of treatment for colorectal cancer liver metastases (CLM). The only limitation of surgery for CLM is its technical feasibility, the key point being to leave enough remnant liver to ensure patient survival. This report describes a surgical procedure based extensively on ultrasound guidance, which allows for curative resection in one stage and also for multiple bilobar CLM. This strategy minimizes the need for two-stage hepatectomy and may thus overcome many of the limitations and consequences of a two-stage approach, such as the impossibility to complete the treatment approach in 20%-25% of patients and the amputation of major vascular structures, which can result in less technical solutions for CLM relapse.