Preoperative laparoscopy and peritoneal lavage in gastric adenocarcinoma: can the approach be modified?

Autor: Carlotto JRM; Hospital de Clínicas de Passo Fundo, Serviço de Cirurgia do Aparelho Digestivo, Passo Fundo, RS, Brasil., Carlotto FM; Universidade de Passo Fundo, Curso de Medicina, Passo Fundo, RS, Brasil., Vesco Neto MD; Hospital de Clínicas de Porto Alegre, Serviço de Cirurgia Geral, Porto Alegre, RS, Brasil., Pastorello J; Hospital de Clínicas de Passo Fundo, Serviço de Oncologia Clínica, Passo Fundo, RS, Brasil., Schmitz LD; Hospital de Clínicas de Passo Fundo, Serviço de Cirurgia do Aparelho Digestivo, Passo Fundo, RS, Brasil., Dal-Vesco JA; Hospital de Clínicas de Passo Fundo, Serviço de Cirurgia do Aparelho Digestivo, Passo Fundo, RS, Brasil.
Jazyk: Portuguese; English
Zdroj: Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2020 Jan 31; Vol. 46 (6), pp. e20192314. Date of Electronic Publication: 2020 Jan 31 (Print Publication: 2020).
DOI: 10.1590/0100-6991e-20192314
Abstrakt: Objective: to assess whether laparoscopy with peritoneal lavage is superior to computed tomography for staging gastric adenocarcinoma and whether it can modify the surgical approach.
Methods: we conducted a retrospective study of 46 patients with gastric adenocarcinoma treated by the digestive surgery team of the Passo Fundo Clinics Hospital (RS), from January 2015 to December 2018, and submitted to laparoscopy with preoperative peritoneal lavage. All patients underwent preoperative clinical staging with computed tomography.
Results: of the 46 patients analyzed, the majority had tumors located in the cardia (34.8%), poorly differentiated (69.6%), and subtype signet ring cells (65.2%). In 91.3%, the computed tomography scan did not identify peritoneal carcinomatosis or distant metastasis. Among these patients with negative computed tomography for distant disease, 21.8% had positive peritoneal lavage for neoplastic cells and had their therapeutic approaches modified.
Conclusion: laparoscopy and peritoneal lavage altered the surgical decision in 21.8% of patients, providing a more reliable preoperative staging in gastric adenocarcinoma.
Databáze: MEDLINE
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