The role of laparoscopic staging for the management of gastric cancer

Abstract

AİM Staging laparoscopy enables us to perform palliative treatment, neo-adjuvant therapy for curative resection or direct curative resection and making a decision with minimal morbidity by avoiding from unnecessary laparotomies. In the present study, the importance of staging lapafoscopy was retrospectively investigated by using clinical and pathologic data. METHODS Data of 70 out of 350 patients who underwent diagnostic laparoscopy due to gastric cancer at Surgical Oncology department between August 2013 and January 2020 were retrospectively analyzed. RESULTS Peritoneal biopsy was positive for malignity in 41 (58.5%) and negative in 29 (41.5%) of the patients who underwent SL. Peritoneal cytology (PC) results were negative in 32 (45.7%) patients and positive in 38 (54.3%) patients. Peritoneal biopsy and cytology results were concurrently positive in 35 patients and concurrently negative in 26 patients. CONCLUSİONS In conclusion, even the most developed imaging methods cannot provide 100% staging, therefore SL plays an important role in treatment of gastric cancer and laparoscopic staging is essential as a simple, inexpensive, safe and well tolerated method in patients who have the suspicion of peritoneal disease and who cannot be clearly evaluated with pre-operative methods.

Polish Consensus on Gastric Cancer Diagnosis and Treatment – Update 2022

“…3. It is recommended to collect multiple samples [6][7][8] during endoscopic examinations for histopathological analysis.…”

“…The voters rejected the absolute requirement to perform a diagnostic laparoscopy due to the possibility it will delay treatment due to additional inpatient stay. However, there is no doubt as to the clinical validity of diagnostic laparoscopy, especially in patients with advanced gastric cancer without clinically evident peritoneal dissemination [8].…”