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Absence of port-site metastases following staging laparoscopy for gastric carcinoma
Deogracias,M. L.; Rodríguez-Sanjuán,J. C.; Torre,F. de la; García,R. A.; Trugeda,M. S.; Domínguez,A.; Gómez-Fleitas,M.;
Revista Espa?ola de Enfermedades Digestivas , 2006, DOI: 10.4321/S1130-01082006001000005
Abstract: background: port-site metastases (psm) have been reported following oncological laparoscopic surgery. however, their frequency after laparoscopic examination in gastric cancer has not been well established. material and methods: prospective follow-up of 41 patients having had a staging laparoscopy and a follow-up longer than 12 months. mean age was 65 years (29-89). after staging, an open gastrectomy was performed in 33 cases. mean follow-up was 21.4 (12-66) months. psm was defined as a node in the former port-site wound with adenocarcinoma histology at biopsy. results: no patient showed clinical signs of psm or port-site recurrence, even in advanced stages. we had no morbidity or postoperative mortality attributable to laparoscopic manoeuvres, and no need for laparotomy in cases without a gastrectomy indication. conclusions: our results suggest that staging laparoscopy is a safe procedure in gastric carcinoma, as it is not associated with psm after even considerable follow-up, and has a very low complication rate.
Simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach  [cached]
Qian-Lin Zhu, Min-Hua Zheng, Bo Feng, Ai-Guo Lu, Min-Liang Wang, Jian-Wen Li, Wei-Guo Hu, Lu Zang, Zhi-Hai Mao, Feng Dong, Jun-Jun Ma, Ya-Ping Zong
World Journal of Gastroenterology , 2008,
Abstract: Laparoscopic resection of rectal cancer or gastric cancer has been advocated for the benefits of a reduced morbidity, a shorter treatment time, and similar outcomes. However, simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach are rarely documented in literature. Endoscopic examination revealed a synchronous carcinoma of rectum and stomach in a 55-year-old male patient with rectal bleeding and epigastric discomfort. He underwent a simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy with regional lymph nodes dissected. The operation time was 270 min and the estimated blood loss was 120 mL. The patient required parenteral analgesia for less than 24 h. Flatus was passed on postoperative day 3, and a solid diet was resumed on postoperative day 7. He was discharged on postoperative day 13. With the advances in laparoscopic technology and experience, simultaneous resection is an attractive alternative to a synchronous gastrointestinal cancer.
Laparoscopic staging in gastric cancer: An essential step in its management  [cached]
Mahadevan D,Sudirman A,Kandasami P,Ramesh G
Journal of Minimal Access Surgery , 2010,
Abstract: Aim: The role of laparoscopy in staging of gastric cancer is widely accepted; however, in Malaysia its usage has been limited. Patients can be classified as resectable or unresectable, which helps in avoiding an unwanted laparotomy and the morbidities associated with it. The aim of this study was to assess the value of laparoscopy in staging of gastric cancer in comparison with CT scan. Materials and Methods: Patients with carcinoma of the stomach after a complete preoperative work-up underwent laparoscopy prior to surgical exploration. TNM staging was used to compare laparoscopy with CT, with the histopathological report used as the gold standard. Results: Forty cases were included in this study. The sensitivity of laparoscopy for T3 tumours appears to be significant when compared to that of CT. Laparoscopy detected 90.3% of the cases as against the 58% detected with CT. There was not much difference in the N factor. With regard to M factor, the sensitivity was 100% for laparoscopy in comparison with CT. Conclusions: Laparoscopy has been shown to be sensitive in detecting metastasis in gastric cancer in comparison to CT, thus helping in avoiding unwanted laparotomy and thus providing a more systemic approach in managing gastric cancers.
Absence of port-site metastases following staging laparoscopy for gastric carcinoma Ausencia de metástasis en los orificios de trócares tras laparoscopia de estadificación en el carcinoma gástrico  [cached]
M. L. Deogracias,J. C. Rodríguez-Sanjuán,F. de la Torre,R. A. García
Revista Espa?ola de Enfermedades Digestivas , 2006,
Abstract: Background: port-site metastases (PSM) have been reported following oncological laparoscopic surgery. However, their frequency after laparoscopic examination in gastric cancer has not been well established. Material and methods: prospective follow-up of 41 patients having had a staging laparoscopy and a follow-up longer than 12 months. Mean age was 65 years (29-89). After staging, an open gastrectomy was performed in 33 cases. Mean follow-up was 21.4 (12-66) months. PSM was defined as a node in the former port-site wound with adenocarcinoma histology at biopsy. Results: no patient showed clinical signs of PSM or port-site recurrence, even in advanced stages. We had no morbidity or postoperative mortality attributable to laparoscopic manoeuvres, and no need for laparotomy in cases without a gastrectomy indication. Conclusions: our results suggest that staging laparoscopy is a safe procedure in gastric carcinoma, as it is not associated with PSM after even considerable follow-up, and has a very low complication rate.
Can Routine Laparoscopy Help to Reduce the Rate of Explorative Laparotomies for Gastric Cancer? Laparoscopy in Gastric Cancer  [PDF]
Gian Carlo Roviaro,Federico Varoli,Davide Sonnino,Ombretta Nucca,Gianni Rabughino,Alessandro Scarduelli
Diagnostic and Therapeutic Endoscopy , 2000, DOI: 10.1155/dte.6.125
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.
The role of endosonography (EUS) in preoperative staging of patients with stomach cancer  [PDF]
Pavlovi? A.R.,Krsti? M.,Tomi? D.,Bjelovi? Milo?
Acta Chirurgica Iugoslavica , 2005, DOI: 10.2298/aci0501053p
Abstract: Background: To evaluate the diagnostic accuracy of endosonography (EUS) in preoperative staging of stomach cancer. Methods: Sixty-two patients with gastric carcinoma were investigated by endosonography. 49 underwent surgery. EUS reports were compared with operative and histology findings. Tumours were staged according to the 2000. TNM classification. Results: EUS had a diagnostic accuracy of 89,8% for the T category, 83,7% for the N category. Conclusion: EUS is an excellent clinical procedure for the staging of local-regional spread of gastric cancer and useful complement to the other gastrointestinal examinations for evaluation of these tumours.
The efficacy of pre-operative laparoscopy in the staging for gastric cancer  [PDF]
Kandasami Palayan
International e-Journal of Science, Medicine & Education , 2012,
Abstract: The only potential curative therapy forgastric cancer is the resection of both the tumor andthe regional lymph nodes at the early stage of thedisease. The majority of patients with gastric cancer inMalaysia have an advanced disease at initial diagnosis,and curative surgery is possible in less than 20% ofoperated cases. Acurate preoperative staging is crucialin determining the most suitable therapy and avoidingunnecessary attempts at curative surgery. Whilecomputed tomography remains as the most widely usedimaging modality for gastric cancer staging, its ability todetect local invasion, peritoneal and liver metastases islimited. In the recent years laparoscopy has become animportant component in the staging algorithm of gastriccancer. The aim of this review is to evaluate the efficacyof routine preoperative laparoscopic staging in themanagement of gastric cancer, and in particular describethe Malaysian experience.
STAGING OF PROSTATIC CARCINOMA
G.M. Subhani
The Professional Medical Journal , 1998,
Abstract: OBJECTIVE: 1). To see the comparative role of serum prostate specific antigen (PSA) and prostatic acidphosphatase (PAP) in the pre-operative staging of prostatic cancer. 2). Their significance in different gradesand different tumor volumes. SETTING: Mayo Hospital Lahore. PERIOD: Sep 1993 to Feb 1995DESIGN Case study METHODS We evaluated 50 patients with adenocarcinoma of the prostate (GroupA). Fifty benign prostatic hyperplasia (BPH) patients serum PSA and PAP was done in all the cases. Tumourvolume was measured by transrectal ultrasonography (TRUS) and were divided into 3 groups (< 5cc, 5-10cc,> lOcc). Grading of the tumour was done (Grade I, II and III) on histopathological examination accordingto the degree of differentiation. RESULTS : In stage ABC and D prostatic carcinoma patients 33.3%,56.0%, 87.5% and 100% patients had serum PSA level even more than lOmg/ml respectively. On the otherhand serum PAP level was within the normal (3.7 u/1) limits in stage A and B prostatic carcinoma patients,while it was raised above the normal limits in 43.7% and 95.5% patients of stage C and D prostaticcarcinoma patients. Serum PSA level was raised above the normal (5ngml) in 4.5% normal subjects but itwas less than lOng/ml and 28% of BPH patients. Serum PAP level was raised above the normal in 2% ofthe BPH patients. Statistically significant difference (P<0.05) in serum PSA value was seen in stage C andD prostatic carcinoma patients when compared with stage A and B prostatic carcinoma and control groups.This was true only in stage D prostatic carcinoma in case of PAP.CONCLUSION Estimation of serum PSA level can better predict variable contribution from tumour differentiation and tumour volume as well asBPH.
Comparison of Staging Systems of Hepatocellular Carcinoma  [PDF]
Yongyut Sirivatanauksorn,Chutwichai Tovikkai
HPB Surgery , 2011, DOI: 10.1155/2011/818217
Abstract: Many staging systems of hepatocellular carcinoma (HCC) were established; however, there is no consensus on which is proper in predicting prognosis. This study aims to evaluate various commonly used staging systems of HCC. Patients who underwent surgery during 2001–2007 were included. All patient data were retrospectively staged using six staging systems, that are American Joint Committee on Cancer (AJCC) Tumour-Node-Metastasis (TNM), Okuda staging, Cancer of the Liver Italian Program (CLIP), Barcelona Clinic Liver Cancer (BCLC), Chinese University Prognostic Index (CUPI), and Japan Integrated Staging (JIS). Child-Pugh classification was also evaluated. The staging systems were compared by mean of overall and disease-free survival. Total of 99 patient data were enrolled in the analyses. All staging systems except Okuda were significant in determining overall survival in univariate analyses. In multivariate analyses, TNM and Child-Pugh demonstrated better predictive power for overall survival. In terms of disease-free survival, univariate analyses revealed that TNM, CLIP, BCLC, CUPI, and JIS were significant, and TNM was the best predictive staging system in multivariate analyses. In our study, TNM and Child-Pugh are the representative systems in predicting survival of HCC patients who undergo surgical resection. Moreover, they are practical and easily assessable in clinical practice. 1. Background Hepatocellular carcinoma (HCC) is the most common primary malignancy of liver and one of the most common malignancies especially in Eastern and Southeastern Asia. The most important risk factors of HCC are chronic hepatitis B, C and cirrhosis. In malignancy diseases, staging system is important because it defines prognosis and is a guiding tool for treatment options and also a research tool for comparison between different groups and trials [1]. American Joint Committee on Cancer (AJCC) uses tumour-node-metastasis (TNM) system as staging system for many malignancy diseases to predict prognosis [2]. Nevertheless, in HCC, AJCC/TNM system fails to stratify patients adequately with respect to prognosis because TNM system evaluates only tumour extension. Since the remnant liver function is another important factor to prognosis of patients with HCC beside tumour burden; therefore, the staging system for HCC should include these both factors [3]. Staging systems that include liver function status were first proposed by Okuda et al. in 1985 based on study of 850 HCC patients [4]. This Okuda staging system was consisted of tumour load, ascites, albumin, and bilirubin.
The Role of Laparoscopy and Laparoscopic Ultrasound in Staging and in Palliation of Upper Gastro-Intestinal Malignancies: The Egyptian National Cancer Institute Experience  [PDF]
Zeiad S. Gad, Waheed Y. Gareer, Osama A. El-Malt, Hussein O. Soliman, Mohamed G. Abdel Menem, Maher H. Ibraheem
Journal of Cancer Therapy (JCT) , 2017, DOI: 10.4236/jct.2017.85040
Abstract: Background: Surgical resection of upper gastrointestinal malignancies occasionally carries substantial morbidity due to inaccurate pre-operative staging. The potential to prevent needless laparotomy by means of precise staging is the pouring force behind the use of diagnostic laparoscopy (DL). Objective: To assess the role of laparoscopy and laparoscopic ultrasound (LUS) in proper staging of upper gastro intestinal malignancies, and in potential palliation in advanced cases for pain (by neurolytic celiac plexus block) or gastric outlet obstruction (by laparoscopic bypass surgery). Study design: In this prospective study, 62 patients with lower esophageal, gastric and peri-pancreatic carcinomas were joined after written informed consent. All patients were examined with laparoscopy and LUS with the help of frozen section analysis to any doubtful metastatic site, peritoneal fluid and ascitic fluid analysis. Results: DL helped us to avoid needless laparotomy in 22.5% of patients, reducing its post-operative complications, hospital stay and cost. DL also helped us to do palliative management either in the form of gastric bypass or laparoscopic celiac plexus block. Conclusion: we praise the use of DL as a safe, effective and complimentary method to the other routine imaging modalities, in proper staging and palliation for upper gastrointestinal malignancies.
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