Laparoscopy and Laparoscopic Ultrasonography in Staging Carcinoma of the Gastric Cardia
| Autor: | O.M. van Delden, Huug Obertop, D. J. Gouma, L. T. de Wit, Jan B F Hulscher, E.J.M. Nieveen van Dijkum, J. J. B. van Lanschot |
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| Přispěvatelé: | Other departments |
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Esophageal Neoplasms Exploratory laparotomy medicine.medical_treatment Digestive System Neoplasms Metastasis Gastrectomy Stomach Neoplasms Biopsy medicine Carcinoma Humans Laparoscopy Aged Retrospective Studies Ultrasonography Aged 80 and over medicine.diagnostic_test business.industry Stomach Cardia Consecutive case series Middle Aged medicine.disease digestive system diseases Surgery Endoscopy medicine.anatomical_structure Female business |
| Zdroj: | European journal of surgery = Acta chirurgica, 166(11), 862-865. Oslo Scandinavian University Press |
| ISSN: | 1102-4151 |
| Popis: | OBJECTIVE: To investigate the role of diagnostic laparoscopy and laparoscopic ultrasonography in the staging of carcinoma of the gastric cardia that is involving the distal oesophagus. DESIGN: Retrospective consecutive case series. SETTING: Tertiary care centre, The Netherlands. SUBJECTS: 48 patients (34 men and 14 women, median age 63 years, range 39-84) who presented with tumours of the gastric cardia that involved the distal oesophagus and in whom non-invasive staging had not shown unresectable locoregional disease or distant metastases. INTERVENTIONS: In addition to laparoscopy and laparoscopic ultrasonography, biopsy of all suspected lesions outside the area of potential resection. MAIN OUTCOME MEASURES: Number of patients in whom the findings obviated the need for exploratory laparotomy. RESULTS: There were no complications related to the laparoscopy. The investigation showed distant metastases (which were histologically verified) in 11 patients (23%, 95% confidence interval (CI) 16 to 30). These patients had non-operative palliation. Seven were identified by laparoscopy, and laparoscopic ultrasonography showed the other four. In three patients whose distant metastases had already been identified by laparoscopy, ultrasonography was omitted. Three additional patients had suspect lesions, but these were not confirmed histologically. However, these lesions were shown to be cancerous at laparotomy. One additional patient had an intra-abdominal metastasis which was missed by laparoscopy with ultrasonography. CONCLUSIONS: Laparoscopy with ultrasonography safely detected metastases that had not been shown by conventional staging investigations in 23% of 48 patients with carcinoma of the gastric cardia. The investigation should therefore be added to the standard staging procedures in patients with carcinoma of the gastric cardia that is involving the distal oesophagus |
| Databáze: | OpenAIRE |
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