Diagnostic and Operative Laparoscopy in Oncology

Abstract

In malignant disease diagnostic laparoscopy is a sensitive technique for diagnosis and staging of intraabdominal tumors. Laparoscopy is particularly valuable for the detection of peritoneal carcinosis and small liver metastases. Increasing interest is also addressed to the use of laparoscopic procedures in surgical oncology. While minimal access surgery is apparently useful for palliative procedures, e.g. gastrostomy, there is much controversy about the feasibility of curative procedures. Presently there is only limited experience with laparoscopic colon resections for colon cancer. This technically complex procedure can result in serious complications. A conversion rate of up to 40% has been reported in the literature. Presently there are no long-term results available confirming the superiority of laparoscopic surgery with respect to survival. Consequently, this technique should be used with caution for the management of carefully selected patients.

The Laparoscopic Janeway Gastrostomy. An Alternative Technique When Percutaneous Endoscopic Gastrostomy Is Impractical

“…The prevention of laparotomy by using laparoscopic gastrostomy offers advantages such as decreased strain on patients and reduced postoperative morbidity, particularly from wound infections, as is the case in other laparoscopic operations [9]. Especially in cases of palliative treatment of patients with malignant disease, the laparoscopic technique should replace the open surgical procedure [10]. Our experiences with four patients and the report of another team [11] also show that previous operations in the upper abdomen do not exclude a laparoscopic gastrostomy.…”

Laparoscopic Colorectal Surgery: Indications and Concept of a Multicenter Study

“…Laparoscopic procedures for colorectal carcinoma w hich can be performed without observance of oncological principles Explorative laparoscopy to exclude or confirm peritoneal or liver metastases Nonresective procedures such as bypass operations or creation of a transverse colon stoma, a sigmoid colon stoma or a loop ileostomy Palliative resections pass operations for advanced carcinoma of the left colon flexure with diffuse liver metastasis or creation of a trans verse colon stoma, a sigmoid colon stoma or a loop ileo stomy in advanced, metastasized colorectal cancer can also be performed laparoscopically [13][14][15][16]. Other indications for laparoscopy could be palliative colorectal resections or extirpation of the rectum in diffuse lung or liver metastasis.…”