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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
ESPINOSA, José Luis; SUAREZ, Liliana María; GUEVARA, Raúl Enrique and MENDIVELSO, Fredy Orlando. Usefulness of staging laparoscopy vs CT scan to detect metastatic peritoneal disease in advanced gastric adenocarcinoma. rev. colomb. cir. [online]. 2019, vol.34, n.3, pp.254-259. ISSN 2011-7582. https://doi.org/10.30944/20117582.439.
Introduction:
Gastric adenocarcinoma is one of the most frequent neoplasms. Abdominal computed tomography is the standard for staging; It has sensitivity of 30 to 73% and specificity of 83 to 100%. Laparoscopy detects up to 30% of negative metastatic disease in images. At Clínica Universitaria Colombia performs routine staging with tomography and laparoscopy plus peritoneal lavage.
Objectives:
To determine the usefulness of laparoscopy for the detection of peritoneal carcinomatosis in patients with advanced gastric adenocarcinoma in a reference center
Materials and methods:
A retrospective descriptive study was carried out, where all the clinical histories of patients with gastric cancer between 2013 and 2016 were analyzed.
Results:
A total of 94 patients with gastric adenocarcinoma were included in the study; Corporal localization was more frequent (47.9%). The tomography reported stage T3 in 56.4%, N0 in 55.3% and M0 97.9%. Laparoscopy reported T3 stage in 43.6%, lymph nodes were involved in 56.4% and the presence of peritoneal carcinomatosis (M1) was 11.7%.
Discussion:
An experienced radiologist shows high detection of peritoneal disease, but laparoscopy detects up to 11% of the disease not evident on images. The peritoneal lavage does not prolong the surgical time nor increases morbidity, which favors its routine performance. We can recommend laparoscopy in patients with negative tomography, avoiding surgery in unresectable disease. Laparoscopy has a positive impact on the management of gastric cancer, according to world literature.
Keywords : stomach neoplasms; peritoneum; laparoscopy; tomography; diagnostic imaging; surgical oncology; neoplasm staging.