BACKGROUND: Noninvasive pretherapeutic staging may be supplemented with laparoscopy and laparoscopic ultrasonography (LUS) in order to detect minute liver metastases, carcinosis or other signs of nonresectable or disseminated disease in patients with upper gastrointestinal tract cancer (UGIC). The aim of this study was to evaluate the use, potential clinical gain, and safety profile of LUS-guided biopsy in patients with UGIC. METHODS: A prospective consecutive study on LUS-guided biopsy in patients referred with UGIC between May 2007 and May 2008 was carried out. Previous noninvasive imaging methods had found no signs of disseminated disease. Laparoscopic or LUS-guided biopsies were only performed if a malignant result would change patient management. RESULTS: Two hundred and nine patients entered the study and, based on predefined biopsy indications, laparoscopy and LUS-guided biopsies changed patient management in a total of 27.3% (54/198) of the patients with a final malignant diagnosis. There were no complications. Liver and pancreas were the main target areas for LUS-guided biopsies, and more than half of the biopsies (55%) were taken from the primary tumor where other modalities had failed to obtain proof of malignancy. Twenty-six percent of biopsies were taken from a suspected metastatic lesion not seen before, whereas 19% were taken from previously suspected metastases where other imaging modalities had failed to obtain proof of malignancy. CONCLUSION: LUS-guided biopsy is a safe procedure which in combination with laparoscopic biopsies had an impact on patient management in one-quarter of UGIC patients.
BACKGROUND: Noninvasive pretherapeutic staging may be supplemented with laparoscopy and laparoscopic ultrasonography (LUS) in order to detect minute liver metastases, carcinosis or other signs of nonresectable or disseminated disease in patients with upper gastrointestinal tract cancer (UGIC). The aim of this study was to evaluate the use, potential clinical gain, and safety profile of LUS-guided biopsy in patients with UGIC. METHODS: A prospective consecutive study on LUS-guided biopsy in patients referred with UGIC between May 2007 and May 2008 was carried out. Previous noninvasive imaging methods had found no signs of disseminated disease. Laparoscopic or LUS-guided biopsies were only performed if a malignant result would change patient management. RESULTS: Two hundred and nine patients entered the study and, based on predefined biopsy indications, laparoscopy and LUS-guided biopsies changed patient management in a total of 27.3% (54/198) of the patients with a final malignant diagnosis. There were no complications. Liver and pancreas were the main target areas for LUS-guided biopsies, and more than half of the biopsies (55%) were taken from the primary tumor where other modalities had failed to obtain proof of malignancy. Twenty-six percent of biopsies were taken from a suspected metastatic lesion not seen before, whereas 19% were taken from previously suspected metastases where other imaging modalities had failed to obtain proof of malignancy. CONCLUSION:LUS-guided biopsy is a safe procedure which in combination with laparoscopic biopsies had an impact on patient management in one-quarter of UGIC patients.
Authors: Carlos Micames; Paul S Jowell; Rebekah White; Erik Paulson; Rendon Nelson; Michael Morse; Herbert Hurwitz; Theodore Pappas; Douglas Tyler; Kevin McGrath Journal: Gastrointest Endosc Date: 2003-11 Impact factor: 9.427
Authors: N Tjarda Van Heek; Steve M M De Castro; Casper H van Eijck; Rutger C I van Geenen; Eric J Hesselink; Paul J Breslau; T C Khe Tran; Geert Kazemier; Mechteld R M Visser; Olivier R C Busch; Hugo Obertop; Dirk J Gouma Journal: Ann Surg Date: 2003-12 Impact factor: 12.969
Authors: Els J M Nieveen van Dijkum; Mark G Romijn; Caroline B Terwee; Laurens Th de Wit; Jan H P van der Meulen; Han S Lameris; Erik A J Rauws; Huug Obertop; Casper H J van Eyck; Patrick M M Bossuyt; Dirk J Gouma Journal: Ann Surg Date: 2003-01 Impact factor: 12.969
Authors: S M M de Castro; E H B M Tilleman; O R C Busch; O M van Delden; J S Laméris; T M van Gulik; H Obertop; D J Gouma Journal: Ann Surg Oncol Date: 2004-05 Impact factor: 5.344
Authors: H E Doran; L Bosonnet; S Connor; L Jones; C Garvey; M Hughes; F Campbell; M Hartley; P Ghaneh; J P Neoptolemos; R Sutton Journal: Dig Surg Date: 2004-09-13 Impact factor: 2.588