胃癌的腹腔镜分期：其治疗中的关键步骤。
Laparoscopic staging in gastric cancer: An essential step in its management.
作者信息
Mahadevan D, Sudirman A, Kandasami P, Ramesh G
机构信息
Department of Surgery, Division of Upper GI Surgery, Tuanku Jaafar Hospital, Seremban, Malaysia.
出版信息
J Minim Access Surg. 2010 Oct;6(4):111-3. doi: 10.4103/0972-9941.72597.
AIM
The role of laparoscopy in staging of gastric cancer is widely accepted; however, in Malaysia its usage has been limited. Patients can be classified as resectable or unresectable, which helps in avoiding an unwanted laparotomy and the morbidities associated with it. The aim of this study was to assess the value of laparoscopy in staging of gastric cancer in comparison with CT scan.
MATERIALS AND METHODS
Patients with carcinoma of the stomach after a complete preoperative work-up underwent laparoscopy prior to surgical exploration. TNM staging was used to compare laparoscopy with CT, with the histopathological report used as the gold standard.
RESULTS
Forty cases were included in this study. The sensitivity of laparoscopy for T3 tumours appears to be significant when compared to that of CT. Laparoscopy detected 90.3% of the cases as against the 58% detected with CT. There was not much difference in the N factor. With regard to M factor, the sensitivity was 100% for laparoscopy in comparison with CT.
CONCLUSIONS
Laparoscopy has been shown to be sensitive in detecting metastasis in gastric cancer in comparison to CT, thus helping in avoiding unwanted laparotomy and thus providing a more systemic approach in managing gastric cancers.
目的
腹腔镜检查在胃癌分期中的作用已被广泛认可；然而，在马来西亚其应用有限。患者可分为可切除或不可切除，这有助于避免不必要的剖腹手术及其相关并发症。本研究的目的是评估腹腔镜检查与CT扫描相比在胃癌分期中的价值。
材料与方法
经过完整术前检查的胃癌患者在手术探查前接受腹腔镜检查。采用TNM分期将腹腔镜检查结果与CT结果进行比较，组织病理学报告作为金标准。
结果
本研究纳入40例患者。与CT相比，腹腔镜检查对T3肿瘤的敏感性似乎更高。腹腔镜检查检测出90.3%的病例，而CT检测出58%。N因素方面差异不大。关于M因素，腹腔镜检查的敏感性为100%，而CT为0。
结论
与CT相比，腹腔镜检查在检测胃癌转移方面已显示出敏感性，从而有助于避免不必要的剖腹手术，因此在胃癌管理中提供了一种更系统的方法。
Zotero 插件