Format

Send to

Choose Destination
See comment in PubMed Commons below
Ann Surg. 1997 Mar;225(3):262-7.

Laparoscopy in the management of gastric adenocarcinoma.

Author information

1
Department of Surgery, Memorial-Sloan Kettering Cancer Center, New York, New York 10021, USA.

Abstract

OBJECTIVE:

The authors determined the accuracy of laparoscopy in detecting metastatic disease in patients with gastric adenocarcinoma.

SUMMARY BACKGROUND DATA:

The majority of patients with gastric adenocarcinoma in the United States present with advanced disease. They are at high risk for intraabdominal metastatic spread.

METHODS:

One hundred eleven patients with gastric adenocarcinoma underwent laparoscopy at Memorial-Sloan Kettering Cancer Center from December 1991 to December 1995. All were judged to be free of intra-abdominal metastatic disease on preoperative computed tomographic scan imaging.

RESULTS:

Laparoscopic exploration was successful in 110 of 111 patients and accurately staged 94% of the patients with respect to metastatic disease with a sensitivity of 84% and a specificity of 100%. The prevalence rate of metastatic disease was 37%. Twenty-four patients underwent laparoscopy only and were discharged in an average 1.4 days versus 6.5 days in patients undergoing exploratory laparotomy without resection (p < 0.05). No patients undergoing laparoscopy only have returned for palliative surgery.

CONCLUSIONS:

Laparoscopy should be performed in nonobstructed, nonbleeding patients with advanced gastric cancer in the United States. More than one third of these patients have unsuspected metastatic disease at time of operation. Laparoscopy is highly accurate in detecting occult metastases and identifies a unique population of stage IV patients who may benefit from newer induction chemotherapeutic approaches while avoiding unnecessary laparotomy.

PMID:
9060581
PMCID:
PMC1190675
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wolters Kluwer Icon for PubMed Central
    Loading ...
    Support Center