Intraoperative observation using a fluorescence imaging instrument during hepatic resection for liver metastasis from colorectal cancer.

Background/aims: We have found that liver metastasis from colorectal cancer (LM-CRC) can be easily detected by its fluorescence using a fluorescence imaging instrument (photodynamic eye (PDE)) in patients who have received an intravenous injection of indocyanine green (ICG). Therefore, our aim is to demonstrate the usefulness of PDE observation for hepatic resection in patients with LM-CRC.

Methodology: Between February and October 2009, seven patients who underwent hepatic resection for LM-CRC were enrolled. After previous ICG injection (0.1mg/kg/mL), PDE observation was performed to detect fine invisible residual tumors on the surface of the resected liver.

Results: All of the 46 resected LM-CRCs that had been pointed out preoperatively were easily detected by their fluorescence using PDE observation. Three of the seven patients underwent additional partial resection because fine invisible residual tumors were detected by their fluorescence using PDE observation. All of these patients who underwent additional resection had no recurrence of LMCRC on the surface of the resected liver after surgery.

Conclusions: PDE observation is useful for detecting fine invisible residual tumors that cannot be revealed under visible light during hepatic resection in patients with LM-CRC and may reduce the incidence of local recurrence on the superficial parenchyma of the liver.