[Laparoscopy and laparoscopic endosonography as staging examination of tumors of the upper gastrointestinal tract]

Abstract

Accurate staging of gastric and oesophageal cancer is of major importance for the therapeutic strategy. However conventional imaging procedures are often not sensitive enough for precise assessment of resectability and curability. In this study laparoscopy and laparoscopic ultrasound were evaluated for preoperative staging.

Patients and methods: Laparoscopy was performed on 21 patients for staging of intraabdominal malignancy using a standard equipment. Laparoscopic ultrasound was done with a flexible echoendoscope equipped with a curved array transducer (5/7,5 MHz). The ultrasound probe was introduced via a 15 mm trocar.

Results: By laparoscopy and laparoscopic ultrasound additional informations compared to conventional staging were obtained and revealed a disseminated disease in 15 out of 21 (71%) patients. These informations induced a change of the initially planned treatment concept in 14 of these patients (67%). A definitive palliative treatment was performed in 5 patients after diagnosis of incurable disease. Laparoscopic ultrasound proved to be useful for the detection of small non superficial lesions followed by biopsy and can improve laparoscopic staging of intraabdominal tumor spread.