[Preoperative diagnostic laparoscopy with local anesthesia and lavage telomerase activity for advanced XXXX ].

@entity1 @entity356
A pretherapeutic staging system to design operative or neoadjuvant treatments in @entity356 is needed. In this study, a simple staging system based on diagnostic laparoscopic findings under local anesthesia to define a treatment was developed. This study was conducted with 68 @entity1 with advanced @entity356 . All the @entity1 had been diagnosed as more than T3, or were suspected to have peritoneal seeding. Preoperative diagnostic laparoscopy under local anesthesia was performed in the operation room. After insertion of the trocars, the abdominal cavity was inspected, and biopsy and/or abdominal lavage sampling was performed. @entity1 were allocated into three stages based on laparoscopic and histopathologic findings. Twenty-eight out of 68 @entity1 were diagnosed as P1, 34 @entity1 as P0CY0 and 6 as P0CY1. Based on these results, 57 @entity1 underwent operation. The accuracy rate of diagnosis was 95% in the P category, and 93% in the CY category. Lavage telomerase activity was examined on 10 @entity1 with P0CY0 @entity356 . Two out of 10 were positive for this activity, and both of them had died due to peritoneal recurrence within a year after operation. In conclusion, the proposed diagnostic laparoscopic staging system is a simple and reproducible method for selection of a suitable therapy. It is considered that diagnostic laparoscopy under local anesthesia is a useful preoperative examination in cases of advanced @entity356 . Moreover lavage telomerase activity may be a more sensitive predictor of peritoneal recurrence than lavage cytology.
