An 18-Year Experience in Diagnostic Laparoscopy of Peritoneal Carcinomatosis: Results from 744 Patients
Autor: | Orietta Federici, Manuel Giofrè, Fabio Carboni, Mario Valle |
---|---|
Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Diagnostic laparoscopy Resection 03 medical and health sciences 0302 clinical medicine Ascites Antineoplastic Combined Chemotherapy Protocols medicine Humans Laparoscopy Peritoneal Neoplasms Retrospective Studies medicine.diagnostic_test business.industry Gastroenterology Perioperative Cytoreduction Surgical Procedures Hyperthermia Induced Surgical procedures Combined Modality Therapy Peritoneal carcinomatosis Surgery 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Hyperthermic intraperitoneal chemotherapy medicine.symptom Neoplasm Recurrence Local business Colorectal Neoplasms |
Zdroj: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 24(9) |
ISSN: | 1873-4626 |
Popis: | Despite accurate preoperative imaging assessment, optimal cytoreductive surgery with hyperthermic intraperitoneal chemotherapy remains unfeasible in many patients with peritoneal carcinomatosis at the time of surgery. The aim of this study was to evaluate the role of diagnostic laparoscopy in the selection of candidates. Prospectively collected data of all patients undergoing diagnostic laparoscopy in our Department were retrospectively analyzed. Demographics and perioperative features as well as operative details and outcome were evaluated. The study included 744 consecutive patients. Primary ovarian tumors were the most common indications, followed by gastric tumors and recurrent colorectal cancers. The procedure was successfully completed in 99.73% of cases. Approximately two thirds of them (68%) had undergone previous surgical procedures. The presence of ascites was recorded in 482 patients (64.78%). A total of 374 (50.3%) patients were excluded from surgical exploration. Among those who eventually underwent surgery, CC0 resection was obtained in 64.6% (239) of cases. Understaging of peritoneal carcinomatosis was observed in 11 patients (1.48%). Postoperative mortality was null and 5 (0.8%) complications were observed. Three (0.4%) port-site metastases were recorded at the beginning of the experience. Diagnostic laparosocopy is a safe and feasible tool able to improve the selection of patients eligible for cytoreduction with hyperthermic intraperitoneal chemotherapy, at the same time allowing avoiding a significant number of unnecessary laparotomies. |
Databáze: | OpenAIRE |
Externí odkaz: |
načítá se...