LESSER SAC ENDOSCOPY IN GASTRIC-CARCINOMA - OPERABILITY ASSESSMENT

Since 1983, endoscopic evaluation of the lesser sac has been used in a ssessing operability in patients with gastric carcinoma. In this prosp ective study, the results of lesser sac endoscopy application in 200 p atients divided into two groups are analyzed. Serosal layer invasion o f the posterior gastric wall was found in 89 patients. Direct retroper itoneal invasion and metastases were found in 97 and 42 patients, resp ectively, and confirmed histopathologically in 24. The reproducibility of the applied method was 96.15 and 99%, the sensitivity of the diagn osis of inoperability was 88.23 and 93.44%, and the sensitivity of the diagnosis of tumor spread was 98 and 98.5%, respectively, in patients of Groups 1 and 2. The use of lesser sac endoscopy, permitting accura te assessment for metastases and visceral and retroperitoneal invasion , was found to allow better staging than laparoscopy alone and thereby reduced by 5.8 times the number of exploratory laparotomies performed in patients with gastric carcinoma.