U. Ribeiro et al., VALUE OF PERITONEAL-LAVAGE CYTOLOGY DURING LAPAROSCOPIC STAGING OF PATIENTS WITH GASTRIC-CARCINOMA, Surgical laparoscopy & endoscopy, 8(2), 1998, pp. 132-135
Forty-nine consecutive patients with advanced gastric carcinoma underw
ent preoperative staging by laparoscopy between June 1991 and June 199
2. Peritoneal lavage with cytologic examination was performed when asc
ites was not present. In eight cases (16.3%), laparoscopy revealed car
cinomatosis and/or multiple hepatic metastases, so laparotomy was not
performed. Intraperitoneal free cancer cells (IFCCs) were detected in
41% of patients (65% in patients with ascites and 28% by peritoneal la
vage). In the absence of macroscopic peritoneal dissemination, IFCCs w
ere encountered in 29% of patients. IFCCs were present only when invas
ion of the gastric serosa was >3 cm(2) or when adjacent organs and str
uctures were already invaded. Mucinous adenocarcinoma, Borrmann class
TV tumors, and Stage IV patients had higher incidence of IFCCs. Cytolo
gic results were similar at laparoscopy and laparotomy (p > 0.05). The
refore, cytologic evaluation of peritoneal lavage added sensitivity to
laparoscopy in assessing patients with advanced gastric carcinoma and
may alter their therapeutic approach.