PRETHERAPEUTIC ASSESSMENT OF RESECTABILITY IN PATIENTS WITH UPPER GASTROINTESTINAL-TRACT CANCER BY USING A COMBINATION OF ENDOSCOPIC ULTRASONOGRAPHY (EUS) AND LAPAROSCOPY
Mb. Mortensen et al., PRETHERAPEUTIC ASSESSMENT OF RESECTABILITY IN PATIENTS WITH UPPER GASTROINTESTINAL-TRACT CANCER BY USING A COMBINATION OF ENDOSCOPIC ULTRASONOGRAPHY (EUS) AND LAPAROSCOPY, Surgical endoscopy, 9(9), 1995, pp. 990-993
An accurate pretherapeutic assessment of resectability in patients wit
h upper gastrointestinal malignancies (UGIM) is mandatory in order to
choose the optimal treatment strategy. Endoscopic ultrasonography (EUS
) has significantly reduced the need for exploratory laparotomy in pat
ients with UGIM, but the pretherapeutic evaluation in about 10% of the
patients is incomplete due to certain limitations of the EUS. We pros
pectively evaluated the use and results of diagnostic laparoscopy in p
atients with UGIM selected for this procedure by EUS. In six patients
with incomplete EUS, laparoscopy demonstrated nonresectability in five
patients and a resectable tumor in one patient, and laparoscopy thus
filled the informational gap in all cases. In addition, laparoscopy co
nfirmed nonresectability in ten patients in whom EUS had suggested non
resectability. By employing the combinated use of EUS and laparoscopy
it seems possible to avoid a great number of futile laparoscopies, and
it should also reduce the need for explorative laparotomies. Larger p
rospective studies have been initiated and might be able to confirm th
is.