A Prospective Study to Evaluate Diagnostic Laparoscopy Function in Patients with Intraabdominal Malignancy with a Focus on Staging
Authors/Creators
- 1. Senior Resident, Department of General Surgery, Govt. Medical College and Hospital, Bettiah, West Champaran, Bihar
- 2. Professor and Head of Department, Department of General Surgery, Govt. Medical College and Hospital, Bettiah, West Champaran, Bihar
Description
Background: The objective of this study is to precisely determine the amount of disease, guide appropriate therapy, and prevent needless intervention using staging laparoscopy. Regular laparoscopy prior to laparotomy, particularly in malignancies with ambiguous operability, aids in reducing needless laparotomies. Methods: Individuals with operable intra-abdominal cancers (carcinomas of the gallbladder, stomach, and colon) will have diagnostic laparoscopy, and the results will be compared to the results of the laparoscopy. Assessment of distant metastases (liver/peritoneum/omentum), resectability of the illness, and biopsies from lesions of ambiguous diagnosis are all included in laparoscopy. Results: Out of the 70 patients included in the study, 58 were radiologically operable, and 12 had unclear operability. Only 30 of these 58 individuals had final resection after a diagnostic laparoscopy revealed they could be surgically removed. 28 patients were left, of whom 14 had isolated peritoneal metastasis, 6 had only hepatic metastasis (single or multiple), and 8 had metastases to both the liver and the peritoneum, as determined by frozen section and histological analysis. Conclusion: The number of needless laparotomies that appear resectable on radiography but are discovered to be irresectable on laparoscopy can be decreased with diagnostic laparoscopy. It can help with the diagnosis of unclear cancers for which image guided biopsy is not advised in radiologically treatable illness (e.g. gall bladder malignancy). By collecting a sample from peritoneal nodules or liver nodules and avoiding a morbidly unneeded laparotomy, it also helps to demonstrate metastatic illness.
Abstract (English)
Background: The objective of this study is to precisely determine the amount of disease, guide appropriate therapy, and prevent needless intervention using staging laparoscopy. Regular laparoscopy prior to laparotomy, particularly in malignancies with ambiguous operability, aids in reducing needless laparotomies. Methods: Individuals with operable intra-abdominal cancers (carcinomas of the gallbladder, stomach, and colon) will have diagnostic laparoscopy, and the results will be compared to the results of the laparoscopy. Assessment of distant metastases (liver/peritoneum/omentum), resectability of the illness, and biopsies from lesions of ambiguous diagnosis are all included in laparoscopy. Results: Out of the 70 patients included in the study, 58 were radiologically operable, and 12 had unclear operability. Only 30 of these 58 individuals had final resection after a diagnostic laparoscopy revealed they could be surgically removed. 28 patients were left, of whom 14 had isolated peritoneal metastasis, 6 had only hepatic metastasis (single or multiple), and 8 had metastases to both the liver and the peritoneum, as determined by frozen section and histological analysis. Conclusion: The number of needless laparotomies that appear resectable on radiography but are discovered to be irresectable on laparoscopy can be decreased with diagnostic laparoscopy. It can help with the diagnosis of unclear cancers for which image guided biopsy is not advised in radiologically treatable illness (e.g. gall bladder malignancy). By collecting a sample from peritoneal nodules or liver nodules and avoiding a morbidly unneeded laparotomy, it also helps to demonstrate metastatic illness.
Files
IJPCR,Vol15,Issue3,Article137.pdf
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Additional details
Dates
- Accepted
-
2023-03-11
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue3,Article137.pdf
- Development Status
- Active
References
- 1. West MA, Hackam DJ, Baker J, Rodriguez JL, Bellingham J, Rotstein OD. Mechanism of decreased in vitro murine macrophage cytokine release after exposure to carbon dioxide: relevance to laparoscopic surgery. Ann Surg. 1997 Aug;226(2):179-90. 2. Kopernik G, Avinoach E, Grossman Y, Levy R, Yulzari R, Rogachev B, Douvdevani A. The effect of a high partial pressure of carbon dioxide environment on metabolism and immune functions of human peritoneal cells-relevance to carbon dioxide pneumoperitoneum. Am J Obstet Gynecol. 1998 Dec;179(6 Pt 1):1503- 10. 3. Wu FP, Sietses C, von Blomberg BM, van Leeuwen PA, Meijer S, Cuesta MA. Systemic and peritoneal inflammatory response after laparoscopic or conventional colon resection in cancer patients: a prospective, randomized trial. Dis Colon Rectum. 2003 Feb;46(2):147- 55. 4. Vallina VL, Velasco JM. The influence of laparoscopy on lymphocyte subpopulations in the surgical patient. Surg Endosc. 1996 May;10(5):481-4. 5. Allendorf JD, Bessler M, Whelan RL, Trokel M, Laird DA, Terry MB, Treat MR. Better preservation of immune function after laparoscopic assisted vs. open bowel resection in a murine model. Dis Colon Rectum. 1996 Oct;39(10 Suppl): S67-72 6. Mandy Perrin, Anaesthesia Critical Care & Pain, Volume 4, Issue 4, 1 August 2004, Pages 107–110 7. Chui PT, Gin T, Oh TE. Anaesthesia for laparoscopic general surgery. Anaesth Intensive Care. 1993; 21: 163 –71. 8. Gutt CN, Kim ZG, Hollander D, Bruttel T, Lorenz M. CO2 environment influences the growth of cultured human cancer cells dependent on insufflation pressure. Surg Endosc. 2001 Mar;15(3):314-8. Epub 2000 Oct 20. 9. Basson MD, Yu CF, Herden-Kirchoff O, Ellermeier M, Sanders MA, Merrell RC, Sumpio BE. Effects of increased ambient pressure on colon cancer cell adhesion. J Cell Biochem. 2000 Apr;78(1):47-61. 10. Volz J, Köster S, Spacek Z, Paweletz N. The influence of pneumoperitoneum used in laparoscopic surgery on an intraabdominal tumor growth. Cancer. 1999 Sep 1;86(5):770-4. 11. Kooby DA. Laparoscopic surgery for cancer: historical, theoretical, andtechnical considerations. Oncology (Williston Park). 2006 Jul;20(8):917- 27; discussion 927-8, 931-2. 12. Yeole BB. Trends in cancer incidence in esophagus, stomach, colon, rectum and liver in males in India. Asian Pac J Cancer Prev. 2008 Jan-Mar;9(1):97- 100. 13. Kindermann, Guenther MD; Maassen, Volker MD; Kuhn, Walter MDLaparoscopic Management of Ovarian Tumors Subsequently Diagnosed as Malignant, Journal of Pelvic Surgery: September 1996. 14. Franklin ME Jr, Rosenthal D, AbregoMedina D, Dorman JP, Glass JL, Norem R, Diaz A. Prospective comparison of open vs. laparoscopic colon surgery for carcinoma. Five-year results. Dis Colon Rectum. 1996 Oct;39(10 Suppl):S35-46. 15. Kwok, SPY, Lau, WY, Carey, PD, Kelly, SB, Leung, KL, Li, AKC 1996Prospective evaluation of laparoscopic-assisted large-bowel excision for cancer.Ann Surg223170176. 16. Stellato TA. History of laparoscopic surgery. Surg Clin North Am. 1992 Oct;72(5):997-1002. 17. Nassour I, Fullington H, Hynan LS, Yopp AC, Augustine MM, Polanco PM, Choti MA, Mansour JC, Wang SC, Porembka MR. The Yield of Staging Laparoscopy in Gastric Cancer is Affected by Racial and Ethnic Differences in Disease Presentation. Ann Surg Oncol. 2017 Jul;24(7):1787- 1794. 18. Krasna MJ, Flowers JL, Attar S, McLaughlin J. Combined thoracoscopic/ laparoscopic staging of esophageal cancer. J Thorac Cardiovasc Surg. 1996 Apr; 111(4): 800-6; discussion 806-7.