Laparoscopy and laparoscopic ultrasonography in staging of XXXX .

@entity1 @entity356 @entity189 @entity418
BACKGROUND: The objective of this prospective study was to assess the contribution of laparoscopy combined with laparoscopic ultrasonography (LLU) in the preoperative staging of @entity1 with @entity189 and @entity418 . STUDY DESIGN: Preoperative LLU was performed in 56 @entity1 who were selected for curative resection of @entity189 (n = 38) or @entity356 with involvement of the distal esophagus (n = 18) after routine preoperative workup. During LLU, the peritoneal cavity was scrutinized for metastatic disease, and ultrasonography of the liver and celiac axis was performed. In all @entity1 without histologically proven metastases, laparotomy was then performed. RESULTS: The morbidity rate of the procedure was 3.5 percent (two superficial wound infections). In three (5 percent) of the 56 @entity1 , laparotomy was excluded by the presence of intra-abdominal metastases. In three other @entity1 , laparotomy was necessary to confirm the suspected hepatic or peritoneal metastases, or both, because histologic proof was not obtained at laparoscopy. In one @entity1 , LLU failed to detect a small hepatic metastasis in segment VII. The preoperative stage was altered by laparoscopy in nine (17 percent) @entity1 (M1 in six, T4 in three). Laparotomy was avoided in two (11 percent) and the preoperative stage changed in seven @entity1 (41 percent), all of whom had @entity356 , as occurred in one (3 percent) and two (6 percent) @entity1 with @entity189 of the esophagus, respectively. CONCLUSIONS: Preoperative staging by LLU is of little value in @entity1 with @entity189 of the middle and lower esophagus. The probable role of LLU in the staging of @entity1 with @entity356 remains to be confirmed in larger series.
