E-ISSN 2587-0610
Laparoscopic Endoscopic Surgical Science Unplanned laparoscopic peritoneal biopsy for gastric cancer [Laparosc Endosc Surg Sci ]
Laparosc Endosc Surg Sci . 2021; 28(2): 116-120 | DOI: 10.14744/less.2021.90008

Unplanned laparoscopic peritoneal biopsy for gastric cancer

Akile Zengin1, Yusuf Murat Bag2, Mehmet Can Aydın3, Fatih Sumer4, Cuneyt Kayaalp5
1Department of Gastrointestinal Surgery, Malatya Training and Research Hospital, Malatya, Turkey
2Department of Gastrointestinal Surgery, Van Training and Research Hospital, Van, Turkey
3Department of Gastrointestinal Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
4Department of Gastrointestinal Surgery, Inonu University Faculty of Medicine, Malatya, Turkey
5Department of Gastrointestinal Surgery, Yeditepe University Faculty of Medicine, Istanbul, Turkey

INTRODUCTION: It is thought that the sensitivity of computed tomography (CT) in detecting peritoneal metastases (PM) is low. In this study, we aimed to present our experience on gastric cancer (GC) patients with intraoperatively detected PM whose preoperative CT was normal in terms of distant metastasis.
METHODS: We retrospectively analyzed the demographics and perioperative data of ten patients with gastric adenocarcinoma whose preoperative CT was normal in terms of PM, but intraoperatively PM was detected.
RESULTS: The mean age of the patients was 68.30±9.44 years. Six patients (60%) were male. Tumors were mostly localized in the distal 1/3 of the stomach (n=5, 50%). The median carcinoembryonic antigen and carbohydrate antigen 19.9 levels were 2.00 ng/ml (0.60–37.50) and 30.76 IU/ml (3.28–449.30), respectively. There were PM on the visceral peritoneum (small bowel mesentery) in two patients (20%) and on the parietal peritoneum in eight patients (80%). The operations were terminated in five patients (50%) when the PM detected as they did not have any complications due to cancer. Laparoscopic feeding jejunostomy (n=2, 20%), laparoscopic tube gastrostomy (n=1, 10%), and laparoscopic gastroenterostomy (n=2, 20%) were performed on the patients with oral intake deficiency due to GC.
DISCUSSION AND CONCLUSION: Preoperative staging with CT before GC surgery is still valid. Multidetector CT scan should be preferred. However, it is still not enough for detecting all PM before surgery. Staging laparoscopy should be in mind, especially for patients with a high risk of PM.

Keywords: Advanced gastric cancer, computed tomography; minimal invasive; peritonitis carcinomatosa.

Akile Zengin, Yusuf Murat Bag, Mehmet Can Aydın, Fatih Sumer, Cuneyt Kayaalp. Unplanned laparoscopic peritoneal biopsy for gastric cancer. Laparosc Endosc Surg Sci . 2021; 28(2): 116-120

Corresponding Author: Akile Zengin, Türkiye
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