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Diagnostic and Therapeutic Endoscopy
Volume 6, Issue 3, Pages 125-131
http://dx.doi.org/10.1155/DTE.6.125

Can Routine Laparoscopy Help to Reduce the Rate of Explorative Laparotomies for Gastric Cancer? Laparoscopy in Gastric Cancer

Department of General Surgery, University of Milan, Ospedale San Giuseppe, FBF, Via San Vittore 12, Milano, 20123, Italy

Received 14 September 1999; Revised 1 November 1999; Accepted 21 December 1999

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

1. Background We developed this surgical protocol about performing intraoperative laparoscopy for staging in every patient affected by stomach cancer. Sensitivity and specificity of intraoperative laparoscopy are compared with conventional preoperative staging techniques.

2. Methods From January 1994 to June 1999, 83 patients affected by stomach cancer were accepted in our department: 12 patients (14.5%) were excluded from our study after the preoperative staging; in 71 patients (85.5%) an explorative laparoscopy as the first step of the operation was performed.

3. Results Laparoscopy confirmed preoperative staging in 53 cases (74.6%), in 12 patients demonstrated an overstaging. Laparoscopy demonstrated in 6 patients unsuspected causes of unresectability.

4. Conclusions When performed in patients affected by malignant neoplasm and declared resectable, intraoperative laparoscopy can demonstrate conditions not detectable by traditional preoperative investigations, consequently reducing to zero explorative laparotomies.