Selection of locally advanced gastric carcinoma by preoperative staging laparoscopy

被引:64
作者
DUgo, DM
Persiani, R
Caracciolo, F
Ronconi, P
Coco, C
Picciocchi, A
机构
[1] Department of General Surgery, A. Gemelli Hospital, Catholic University of Rome, 00168 - Rome, Largo Gemelli
[2] Department of General Surgery, G. Moscati Hospital, 83100 - Avellino
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 1997年 / 11卷 / 12期
关键词
laparoscopy; gastric cancer staging; neoadjuvant chemotherapy;
D O I
10.1007/s004649900560
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The present study is a prospective evaluation of immediate preoperative laparoscopy compared to ultrasound/computed tomography (US/CT) staging for gastric cancer in a series of 100 patients observed at two major Italian hospitals from April 1995 through September 1996. Methods: After a complete preoperative work-up all c-MO patients underwent laparoscopy immediately prior to an eventual surgical exploration, pTNM was considered as the gold standard for the evaluation of the results. Results: Laparoscopy detected 21 unsuspected M+ cases out of 100. As regards locally advanced tumors, laparoscopy showed a sensibility of 69.7% for T3 and 89.6% for T4, significantly higher than US/CT staging (23.2% and 48.3%, respectively; p < 0.02), In this series laparoscopic staging altered clinical staging in 58% of cases. Conclusions: This procedure plays two crucial roles in the preoperative evaluation of advanced gastric cancer: It makes it possible to avoid unnecessary surgical exploration in M+ cases and, to date, it represents the most reliable and economic tool for the selection of locally advanced tumors in the light of neoadjuvant treatment.
引用
收藏
页码:1159 / 1162
页数:4
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