BACKGROUND: Staging laparoscopy has been shown to be useful for increasing the accuracy of preoperative staging. However, controversy still exists regarding patient selection and subsequent treatment. The aim of this study was to determine the role of staging laparoscopy for a group that has a policy to perform aggressive surgery for advanced gastric cancer. METHODS: Twenty-four patients with clinical T3 or T4 gastric cancer expected to undergo curative resection, based on conventional preoperative diagnostic methods underwent staging laparoscopy. We examined the accuracy and the impact of staging laparoscopy on the further treatment options. RESULTS: The mean running time for the staging laparoscopy was 40.7 min (range: 25-75 min), and one complication was noted (4.2%). In regard to the tumor depth, 11 of 24 (45.8%) cases had a discrepancy after staging laparoscopy. In addition, 15 of 24 patients (62.5%) were found to have unsuspected peritoneal metastases, and 8 patients (33.3%) were excluded from laparotomy. The remaining 16 patients (66.7%), including 9 patients with localized peritoneal metastases (P1), underwent resection. The diagnostic accuracy for T factor was 81.3% in 16 laparotomy cases and overall accuracy of P factor was 91.7%. CONCLUSIONS: Staging laparoscopy had a significant impact on decisions regarding the treatment plan in patients with advanced gastric cancer for a group that has an aggressive treatment strategy.
BACKGROUND: Staging laparoscopy has been shown to be useful for increasing the accuracy of preoperative staging. However, controversy still exists regarding patient selection and subsequent treatment. The aim of this study was to determine the role of staging laparoscopy for a group that has a policy to perform aggressive surgery for advanced gastric cancer. METHODS: Twenty-four patients with clinical T3 or T4 gastric cancer expected to undergo curative resection, based on conventional preoperative diagnostic methods underwent staging laparoscopy. We examined the accuracy and the impact of staging laparoscopy on the further treatment options. RESULTS: The mean running time for the staging laparoscopy was 40.7 min (range: 25-75 min), and one complication was noted (4.2%). In regard to the tumor depth, 11 of 24 (45.8%) cases had a discrepancy after staging laparoscopy. In addition, 15 of 24 patients (62.5%) were found to have unsuspected peritoneal metastases, and 8 patients (33.3%) were excluded from laparotomy. The remaining 16 patients (66.7%), including 9 patients with localized peritoneal metastases (P1), underwent resection. The diagnostic accuracy for T factor was 81.3% in 16 laparotomy cases and overall accuracy of P factor was 91.7%. CONCLUSIONS: Staging laparoscopy had a significant impact on decisions regarding the treatment plan in patients with advanced gastric cancer for a group that has an aggressive treatment strategy.
Authors: Gary M Spence; David I Watson; Glyn G Jamiesion; Carolyn J Lally; Peter G Devitt Journal: J Gastrointest Surg Date: 2006-05 Impact factor: 3.452
Authors: David I Watson; Glyn G Jamieson; Carolyn Lally; Stephen Archer; Justin R Bessell; Michael Booth; Richard Cade; Graham Cullingford; Peter G Devitt; David R Fletcher; James Hurley; George Kiroff; Christopher J Martin; Ian J G Martin; Leslie K Nathanson; John A Windsor Journal: Arch Surg Date: 2004-11
Authors: Ibrahim Nassour; Hannah Fullington; Linda S Hynan; Adam C Yopp; Mathew M Augustine; Patricio M Polanco; Michael A Choti; John C Mansour; Sam C Wang; Matthew R Porembka Journal: Ann Surg Oncol Date: 2017-02-13 Impact factor: 5.344
Authors: Jung Ho Shim; Han Mo Yoo; Han Hong Lee; Jun Gi Kim; Hae Myung Jeon; Kyo Young Song; Cho Hyun Park Journal: Surg Endosc Date: 2011-05-02 Impact factor: 4.584