Laparoscopic staging of gastric cancer: an overview

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Abstract
Jacobaeus, 1 Jacobaeus H.C Kurze Übersicht über meine Erfahrungen mit der Laparoskopie. Münch Med Wochenschr. 1911; 58 : 2017-2019 Google Scholar who first used the term laparoscopy in 1911, pointed out the enormous diagnostic implications of this technique, indicating that by using a laparoscope, diagnoses of cirrhosis, tuberculous peritonitis, and metastatic tumors could be confirmed. With the advances in video endoscopy and the addition of television monitoring, current techniques of laparoscopy using improved imaging have led to the widest application in the diagnosis of abdominal malignancy. 2 Greene F.L Laparoscopy in malignant disease. Surg Clin North Am. 1992; 72 : 1125-1136 PubMed Google Scholar One of the first important experiences involving the use of laparoscopy for the staging of gastric neoplasms was reported by Gross and colleagues 3 Gross E Bancewicz J Ingram G Assessment of gastric cancer by laparoscopy. Br Med J (Clin Res Ed). 1984; 288 : 1577 Crossref PubMed Scopus (42) Google Scholar in 1984 in a series of 46 cases. This report was followed by many others that we will discuss in this article. At present, a number of published articles suggest that laparoscopy is indeed capable of solving the majority of the problems related to gastric cancer staging, giving the unique opportunity of an accurate selection of patient subgroups on the basis of their precise clinical stage and specific prognosis, with the final goal of an individually “stage-adapted” treatment. 4 Possik R.A Franco E.L Pires D.R et al. Sensitivity, specificity and predictive value of laparoscopy for the staging of gastric cancer and for the detection of liver metastases. Cancer. 1986; 58 : 1-6 Crossref PubMed Scopus (117) Google Scholar , 5 Kriplani A.K Kapur B.M.L Laparoscopy for pre-operative staging and assessment of operability in gastric carcinoma. Gastrointest Endosc. 1991; 37 : 441-443 Abstract Full Text PDF PubMed Scopus (100) Google Scholar , 6 Lowy A.M Mansfield P.F Steven D et al. Laparoscopic staging for gastric cancer. Surg. 1996; 119 : 611-614 Abstract Full Text PDF PubMed Scopus (144) Google Scholar , 7 Stell D.A Carter C.R Stewart I et al. Prospective comparison of laparoscopy, ultrasonography and computed tomography in the staging of gastric cancer. Br J Surg. 1996; 86 : 1260-1262 Crossref Scopus (132) Google Scholar , 8 Burke E.C Karpeh M.S Conlon K.C et al. Laparoscopy in the management of gastric adenocarcinoma. Ann Surg. 1997; 225 : 262-267 Crossref PubMed Scopus (246) Google Scholar , 9 D’Ugo D.M Persiani R Caracciolo F et al. Selection of locally advanced gastric carcinoma by preoperative staging laparoscopy. Surg Endosc. 1997; 11 : 1159-1162 Crossref PubMed Scopus (68) Google Scholar But there is still some concern about possible implications of diagnostic laparoscopy for abdominal malignancies, because many authors have reported the development of port-site metastases and peritoneal seeding after laparoscopic manipulation of a tumor.