Staging laparoscopy for gastric cancer

Surgical resection remains the only potentially curative treatment of patients with gastric cancer. Evaluation of surgery and other treatments depends on accurate staging of the disease. The objective of the study was to compare staging laparoscopy with ultrasonography, endoscopic ultrasound, computed tomography, and histology for serosal infiltration, lymph node metastasis, peritoneal seeding, and hepatic metastasis. Diagnostic laparoscopy was carried out in 48 patients. Prelaparoscopic staging in all cases included upper gastrointestinal endoscopy and biopsies followed by endosonography, ultrasound, and computed tomography. Preoperative combined examination using CT and laparoscopy was superior when compared with each modality alone or the combinations of the other tests. The present study showed that preoperative evaluation of patients with laparoscopy is superior to all other diagnostic tests. We also found that laparoscopy and computed tomography were better in accurately assessing the serosal infiltration, peritoneal seeding, and hepatic metastases, which thus allows the surgeon to choose more effective treatment modality.