Skip to main content
SpringerLink
Log in

Diagnostic laparoscopy and laparoscopic ultrasonography optimize the staging and resectability of intraabdominal neoplasms

  • Original Articles
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Despite technical improvements, preoperative imaging studies often fail to predict intraoperative findings. We investigated the potential use of diagnostic laparoscopy (DL) and laparoscopic ultrasonography (LUS) for the assessment of disease in patients with abdominal neoplasms.

Methods

Fifty consecutive patients with abdominal neoplasms underwent spiral computed tomography with oral and intravenous contrast using 5-mm contiguous sections. In addition, eight patients underwent ultrasonography, six underwent magnetic resonance imaging, and eight underwent positron emission tomography. All patients then underwent DL and LUS using a 7.5-MHz ultrasound probe.

Results

There were 29 men and 21 women with a mean age of 63 years (range, 35–84). Most had a diagnosis of colorectal cancer (19 cases), melanoma (12 cases), or hepatoma (five cases). In nine cases (18%), DL revealed peritoneal metastatic implants not shown on preoperative images. In 18 cases (36%), LUS was more accurate than preoperative imaging. Combined DL and LUS findings radically changed the operative management in 16 patients (32%).

Conclusion

As compared with preoperative imaging, the combination of DL and LUS provides more accurate information regarding staging and resectability. Moreover, it helps to determine the extent of operation and reduces the number of unnecessary laparotomies. DL and LUS should be used as an adjunct to preoperative imaging studies in patients with primary or metastatic intraabdominal neoplasms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Barbot DJ, Marks JH, Feld RI, Liu JB, Rosato FE (1997) Improved staging of liver tumors using laparoscopic intraoperative ultrasound. J Surg Oncol 64: 63–67

    Article  PubMed  CAS  Google Scholar 

  2. Bezzi M, Silecchia G, De Leo A, Carbone I, Pepino D, Rossi P (1998) Laparoscopic and introperative ultrasound. Eur J Radiol 27: S207-S214

    Article  PubMed  Google Scholar 

  3. Callery MP, Strasberg SM, Doherty GM, Soper NJ, Norton JA (1997) Staging laparoscopy with laparoscopic ultrasonography: optimizing resectability in hepatobiliary and pancreatic malignancy. J Am Coll Surg 185: 33–39

    PubMed  CAS  Google Scholar 

  4. Cuesta MA, Meijer S, Borgstein PJ (1992) Laparoscopy and assessment of digestive tract cancer. Br J Surg 79: 486–487

    Article  PubMed  CAS  Google Scholar 

  5. Cuesta MA, Meijer S, Borgstein PJ, Mulder LS, Sikkenk AC (1993) Laparoscopic ultrasonography for hepatobiliary and pancreatic malignancy. Br J Surg 80: 1571–1574

    Article  PubMed  CAS  Google Scholar 

  6. Cushieri A (1995) Laparoscopic management of cancer patients. J R Coll Surg Engl 40: 1–9

    Google Scholar 

  7. Feld RI, Liu JB, Nazarian L, Lev-Toaff AS, Needleman L, Rawool NM, Merton DA, Segal SR, Rosato FE, Barbot DJ, Goldberg BB (1996) Laparoscopic liver sonography: preliminary experience in liver metastases compared with CT portography. J Ultrasound Med 15: 289–295

    Google Scholar 

  8. Goletti O, Buccianti P, Chiarugi M, Pieri L, Sbragia P, Cavina E (1995) Laparoscopic sonography in screening metastases from gastro-intestinal cancer: comparative accuracy with traditional procedures. Surg Laparosc Endosc 5: 176–182

    PubMed  CAS  Google Scholar 

  9. John TG, Grieg JD, Crosbie JL, Miles WFA, Garden OJ (1994) Superior staging of liver tumors with laparoscopy and laparoscopic ultrasound. Ann Surg 220: 711–719

    Article  PubMed  CAS  Google Scholar 

  10. John TG, Wright A, Allan PL, Redhead DN, Paterson-Brown Simon, Carter DC, Garden OJ (1999) Laparoscopy with laparoscopic ultrasonography in the TNM staging of pancreatic carcinoma. World J Surg 23: 870–881

    Article  PubMed  CAS  Google Scholar 

  11. Kane RA (1999) Intraoperative, laparoscopic and endoluminal ultrasound. Churchill-Livingston, Philadelphia, pp

    Google Scholar 

  12. Lightdale CJ (1992) Laparoscopy for cancer staging. Endoscopy 24: 682–686

    Article  PubMed  CAS  Google Scholar 

  13. Mahfouz AE, Hamm B, Mathieu SR (1996) Imaging of metastases to the liver. Eur Radiol 6: 607–614

    Article  PubMed  CAS  Google Scholar 

  14. Minnard EA, Conlon KC, Hoos A, Dougherty EC, Hann LE, Brennan MF (1998) Laparoscopic ultrasound enhances laparoscopy in the staging of pancreatic cancer. Ann Surg 228: 182–187

    Article  PubMed  CAS  Google Scholar 

  15. Rahusen FD, Cuesta MA, Borgstein PJ, Bleichrodt RP, Barkhof F, Doesburg T, Meijer S (1999) Selection of patients for resection to the liver using diagnostic laparoscopy and laparoscopic ultrasound. Ann Surg 230: 31–37

    Article  PubMed  CAS  Google Scholar 

  16. Schirmer B (1994) Laparoscopic ultrasonography. Ann Surg 220: 709–710

    Article  PubMed  CAS  Google Scholar 

  17. Siperstein AE, Rogers SJ, Hansen PD, Gitomirsky A (1997) Laparoscopic thermal ablation of hepatic neuroendocrine tumor metastases. Surgery 122: 1147–1455

    Article  PubMed  CAS  Google Scholar 

  18. Sugarbaker PH (1990) Surgical decision making for large bowel cancer metastatic to the liver. Radiology 174: 621–626

    PubMed  CAS  Google Scholar 

  19. Van Delden OM, de Wit LT, van Dijkum EJ, Reeders JW, Gouma DJ (1998) Laparoscopic ultrasonography for abdominal tumor staging. Eur Radiol 8: 1405–1408

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. John Wayne Cancer Institute, Saint John’s Health Center, 2200 Santa Monica Boulevard, 90404, Santa Monica, CA, USA

    G. J. Tsioulias, T. F. Wood, M. H. Chung, D. L. Morton & A. Bilchik

Authors
  1. G. J. Tsioulias
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. F. Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. H. Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. L. Morton
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Bilchik
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Online publication: 12 June 2001

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tsioulias, G.J., Wood, T.F., Chung, M.H. et al. Diagnostic laparoscopy and laparoscopic ultrasonography optimize the staging and resectability of intraabdominal neoplasms. Surg Endosc 15, 1016–1019 (2001). https://doi.org/10.1007/s004640080094

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004640080094

Key words

Search

Navigation