Laparoscopy in gastric cancer staging

Abstract EN

Background : Cancer of the stomach carries poor prognosis.

Prediction of survival depends on the time of presentation.

Fluoroscopy, sonography, and computerized tomography are used for staging of advanced gastric cancers, but these are not accurate enough for grading of advanced gastric cancers.

Laparoscopic finding in which lesions are directly seen up to 15 times magnified, has been used for gastric cancer staging.

Method : To examine the importance of laparoscopy, we carried out this study over 84 confirmed cases of gastric cancer prior to laparotomy.

Results of sonography and computerized tomography were compared with the findings of laparoscopies.

Results : Beside 54 cases that were reported without metastases by sonography and computerized tomography, there were 34 patients with a variety of different metastases found in laparoscopic examinations.

The findings were as follow : Multiple small foci in a liver lobe (four cases) Multiple small foci in two lobes (four cases) Characterized metastatic focus in one lobe (10 cases) Multiple foci in two lobes with multiple deposits in peritoneum (16 cases).

Out of thirty patients who were suspected to have intra-abdominal mitoses or were reported to have some malignant lesions by sonography and computerized tomography, 20 patients (66%) had inoperable advanced lesions.

Conclusion : Laparoscopic examination is a valuable tool for diagnosing metastases and should be used in management of advanced gastric cancers.

This study suggests that in terminally ill patients, and in advanced gastric cancer where surgery may be ineffective, laparoscopic examination may predict and avoid unnecessary surgical interventions.