Wu HR, Bu H, Liu YY, Zhou HP, Ye JS, Chen H. Intraoperative laparoscopic ultrasound-guided resection and microwave ablation for colorectal liver metastases. World J Gastrointest Oncol 2025; 17(8): 107526 [DOI: 10.4251/wjgo.v17.i8.107526]
Corresponding Author of This Article
Hua Chen, Professor, Department of General Surgery, Changde Hospital, Xiangya School of Medicine, Central South University, No. 818 Renmin Road, Wuling District, Changde 415000, Hunan Province, China. monday202003@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Aug 15, 2025; 17(8): 107526 Published online Aug 15, 2025. doi: 10.4251/wjgo.v17.i8.107526
Intraoperative laparoscopic ultrasound-guided resection and microwave ablation for colorectal liver metastases
Hao-Ran Wu, Hao Bu, You-Yuan Liu, Hou-Ping Zhou, Jing-Song Ye, Hua Chen
Hao-Ran Wu, Hao Bu, Hou-Ping Zhou, Jing-Song Ye, Hua Chen, Department of General Surgery, Changde Hospital, Xiangya School of Medicine, Central South University, Changde 415000, Hunan Province, China
You-Yuan Liu, Department of Ultrasound, Changde Hospital, Xiangya School of Medicine, Central South University, Changde 415000, Hunan Province, China
Co-first authors: Hao-Ran Wu and Hao Bu.
Co-corresponding authors: Jing-Song Ye and Hua Chen.
Author contributions: Wu HR and Bu H designed the research study as the co-first authors of the paper; Wu HR, Bu H, Zhou HP, Ye JS, and Chen H performed the research; Wu HR and Zhou HP collected and analyzed the data; Bu H and Ye JS drafted the manuscript; Ye JS and Chen H critically revised the manuscript and gave final approval of the version to be published as co-corresponding authors; all of the authors have sufficiently participated in the work to take public responsibility for appropriate portions of the content and agreed to be accountable for all aspects of the work in ensuring its accuracy and integrity.
Supported by National Clinical Key Specialty Major Research Project of Hunan Provincial Health Commission in 2023, No. Z2023165.
Institutional review board statement: The study was reviewed and approved by Changde Hospital, Xiangya School of Medicine, Central South University.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at monday202003@163.com. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hua Chen, Professor, Department of General Surgery, Changde Hospital, Xiangya School of Medicine, Central South University, No. 818 Renmin Road, Wuling District, Changde 415000, Hunan Province, China. monday202003@163.com
Received: April 8, 2025 Revised: May 8, 2025 Accepted: July 8, 2025 Published online: August 15, 2025 Processing time: 127 Days and 15.7 Hours
Abstract
BACKGROUND
Colorectal cancer (CRC) frequently metastasizes to the liver, significantly compromising patient survival. While surgical resection improves outcomes for resectable cases, many patients have limited therapeutic options.
AIM
To evaluate the role of laparoscopic ultrasound in resection and ablation of colorectal liver metastases (CRLM).
METHODS
Between June 2018 and June 2020, 300 patients with CRC and liver metastases were admitted to our hospital. They were divided into two groups (150 cases each) based on treatment method: The control group (ethoxybenzyl diethylenetriamine penta-acetic acid enhanced magnetic resonance imaging) and the observation group [contrast-enhanced ultrasound with Sonazoid (S-CEUS)].
RESULTS
The study group demonstrated better efficacy (P < 0.05), fewer adverse events (P < 0.05), and better survival outcomes compared to the control group (1-year: 80% vs 62%; 3-year: 54% vs 33%; 5-year: 32% vs 18%; median survival: 48 months vs 30 months; hazard ratio = 0.63, 95%CI: 0.48-0.83, P < 0.001). Although Karnofsky Performance Status scores improved in both groups, the scores were significantly higher in the observation group (P < 0.05). Multivariate analysis confirmed intraoperative S-CEUS and tumor differentiation as independent prognostic factors (P < 0.05).
CONCLUSION
Laparoscopic ultrasound-guided resection/ablation improved outcomes in CRLM, reducing complications and enhancing survival. Intraoperative S-CEUS was an independent prognostic factor, supporting its clinical value.
Core Tip: This study demonstrates that intraoperative laparoscopic ultrasound [contrast-enhanced ultrasound with Sonazoid (S-CEUS)]-guided surgical resection and microwave ablation significantly enhances clinical outcomes in colorectal cancer liver metastasis patients compared to preoperative ethoxybenzyl diethylenetriamine penta-acetic acid enhanced magnetic resonance imaging planning. The S-CEUS group exhibited superior oncologic efficacy (higher 5-year survival: 32% vs 18%), fewer adverse events, and improved quality of life (Karnofsky Performance Status scores). Multivariate analysis confirmed intraoperative S-CEUS utilization and primary tumor differentiation as independent prognostic factors. These findings highlight S-CEUS-guided strategies as a critical advance in optimizing oncologic precision and long-term survival in metastatic liver surgery, warranting broader clinical adoption.
