Unplanned laparoscopic peritoneal biopsy for gastric cancer
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Date
2021
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info:eu-repo/semantics/openAccess
Abstract
Introduction: It is thought that the sensitivity of computed tomography (CT) in detecting peritoneal metas tases (PM) is low. In this study, we aimed to present our experience on gastric cancer (GC) patients withintraoperatively detected PM whose preoperative CT was normal in terms of distant metastasis. Materials and Methods: We retrospectively analyzed the demographics and perioperative data of ten pa tients with gastric adenocarcinoma whose preoperative CT was normal in terms of PM, but intraoperativelyPM was detected. Results: The mean age of the patients was 68.30±9.44 years. Six patients (60%) were male. Tumors weremostly localized in the distal 1/3 of the stomach (n=5, 50%). The median carcinoembryonic antigen andcarbohydrate antigen 19.9 levels were 2.00 ng/ml (0.60–37.50) and 30.76 IU/ml (3.28–449.30), respectively.There were PM on the visceral peritoneum (small bowel mesentery) in two patients (20%) and on the parietalperitoneum in eight patients (80%). The operations were terminated in five patients (50%) when the PM de tected as they did not have any complications due to cancer. Laparoscopic feeding jejunostomy (n=2, 20%),laparoscopic tube gastrostomy (n=1, 10%), and laparoscopic gastroenterostomy (n=2, 20%) were performedon the patients with oral intake deficiency due to GC. Conclusion: Preoperative staging with CT before GC surgery is still valid. Multidetector CT scan should bepreferred. However, it is still not enough for detecting all PM before surgery. Staging laparoscopy should bein mind, especially for patients with a high risk of PM.
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Journal or Series
Laparoscopic Endoscopic Surgical Science
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Volume
28
Issue
2
