Selection of locally advanced gastric carcinoma by preoperative staging laparoscopy.

Autor:	D'Ugo, D. M., Persiani, R., Caracciolo, F., Ronconi, P., Coco, C., Picciocchi, A.
Předmět:	ADENOCARCINOMA ALGORITHMS COMBINED modality therapy COMPARATIVE studies COMPUTED tomography DECISION trees LAPAROSCOPY LONGITUDINAL method RESEARCH methodology MEDICAL cooperation METASTASIS PREOPERATIVE care RESEARCH RESEARCH evaluation STOMACH tumors UNNECESSARY surgery TUMOR classification ULTRASONIC imaging VIDEO recording EVALUATION research PREDICTIVE tests PATIENT selection
Zdroj:	Surgical Endoscopy; Dec1997, Vol. 11 Issue 12, p1159-1162, 4p
Abstrakt:	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-M0 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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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