Combined preoperative endoscopic and laparoscopic ultrasonography for prediction of R0 resection in upper gastrointestinal tract cancer

Abstract

The routine use of EUS and LUS before surgery predicted R0 resection in nine of ten patients and reduced the number of unnecessary laparotomies to less than 3 per cent.

Combined pretherapeutic endoscopic and laparoscopic ultrasonography may predict survival of patients with upper gastrointestinal tract cancer

“…Details regarding imaging methods, resectability criteria, interpretation, and test performance of the ultrasonographic findings have been described previously [13]. Thus, all patients had a resectability assessment and a TNM stage assigned based on EUS-LUS findings before any type of treatment was provided.…”

“…A pretherapeutic assessment of resectability based on the combination of EUS and laparoscopy with laparoscopic ultrasonography (LUS) seems superior to EUS alone [13], but there are no data on the ability of this combined approach to predict survival. In addition, no studies have compared the prognosis after patient selection by the EUS-LUS imaging strategy and the prognosis of patients selected by computed tomography (CT)-based imaging.…”

Laparoscopic ultrasound-guided biopsy in upper gastrointestinal tract cancer patients

“…The exact number of preoperative imaging modalities was not recorded, but all patients were subsequently evaluated in a multidisciplinary tumor conference, and only patients without sign(s) of local nonresectability [2] or disseminated disease were included in the study.…”

“…However, none of these techniques are sensitive enough to detect all patients with advanced or disseminated disease, and therefore laparoscopy has been used as the last imaging method prior to open surgery [1]. The inherent inability of standard laparoscopy to look below visible surfaces led to the introduction of laparoscopic ultrasound (LUS), which in combination with EUS or CT provided additional data on tumor stage and resectability [2]. Detailed intra-abdominal LUS examination may reveal lesions suggesting disseminated disease (e.g., malignant lymph nodes, minute liver metastases or local tumor infiltration), but in order to classify a potential lesion as metastatic, histological or cytological proof of malignancy has to be obtained.…”

Ecoendoscopia na avaliação pré-operatória do estádio em doentes com câncer gástrico: correlação com os achados cirúrgicos e/ou histopatológicos

“…A classif icação da doença dentre os estádios TNM pode ser obtida com combinações de métodos (5,45) . Nesse campo, abre-se cada vez mais espaço para a ultra-sonografia laparoscópica por reunir as informações macroscópicas da laparoscopia (33,37,39) e dados semelhantes na categoria T e superiores na N aos da EE (14) . Destarte, do ponto de vista prático, este estudo revela que por exemplo, para classificar uma lesão em T3 o exame ecoendoscópico permite o diagnóstico correto em 86% dos casos.…”