Is There Additional Information from Laparoscopic Ultrasound in Tumor Staging?

Rau, Beate; Hünerbein, M.; Schlag, Peter M.

doi:10.1159/000067600

Cited by 21 publications

(16 citation statements)

References 23 publications

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“…In the late 1980s and early 1990s, several studies proved IOUS to be more accurate in detecting liver metastases than the existing scanning methods, including extracorporeal US, CT, MRI, and surgical exploration [14,15,16,17]. In our study, ILUS was used to look for satellite lesions in all malignant cases; however, there were no positive findings.…”

Section: Discussionmentioning

confidence: 58%

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Kang¹,

Niu²,

Zhang³

et al. 2012

Urol Int

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Objective: To evaluate the value of intraoperative laparoscopic ultrasonography (ILUS) in retrolaparoscopic nephron-sparing surgery. Methods: A total of 81 cases were studied during a 5-year period: 38 patients with a benign renal tumor who underwent enucleation of the tumor and 43 patients with a suspected malignant renal tumor who underwent wedge resection of the tumor. ILUS was used to evaluate renal perfusion, locate the tumor, precisely delineate the tumor border, characterize the tumor, and look for any suspected satellite renal masses. Results: All procedures were successful without conversion to open surgery. The mean operating time was 106 min for enucleation (range 70– 150 min) and 114 min for wedge resection (range 80– 235 min). The mean size of benign tumors was 4.02 cm and that of malignant tumors was 3.13 cm, and all margins were negative. An additional renal artery branch was detected in 11 patients. In 2 cases the operative procedure was changed based on the ILUS findings. No satellite lesion was found in any of the patients with malignant tumors. Conclusions: ILUS provides significant benefit in retrolaparoscopic nephron-sparing surgery. In a number of situations, especially endogenic lesions, it is an essential surgical tool.

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Section: Discussionmentioning

confidence: 58%

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Kang¹,

Niu²,

Zhang³

et al. 2012

Urol Int

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“…Six of the eight patients with false-positive results had intrahepatic cholestasis (compared to 3 of 15 patients with true-positive lesions), 1 had an infrahepatic abscess and the remaining patient had a right basal lung metastasis [39]. In the present study FDG PET identified disseminated disease in only 5 of 10 patients with positive laparoscopic findings and therefore cannot be seen as a substitute for laparoscopic staging [51,52,53]. …”

Section: Discussionmentioning

confidence: 62%

Positron Emission Tomography Does Not Add to Computed Tomography for the Diagnosis and Staging of Pancreatic Cancer

Lytras¹,

Connor²,

Bosonnet³

et al. 2005

Dig Surg

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Background: Positron emission tomography (PET) has been proposed for pancreatic cancer diagnosis and staging. Methods: 112 patients with suspected pancreatic cancer underwent ¹⁸F-fluoro-2-deoxy-D-glucose gamma camera PET and computed tomography (CT), of whom 62 also had laparoscopic ultrasonography and 70 underwent abdominal exploration for potential resection. The final diagnosis was malignancy in 78 and benign disease in 34 patients (25 with chronic pancreatitis). Results: The diagnostic sensitivity and specificity for PET were 73 and 60% compared to 89 and 65% for CT respectively (Cohen’s ĸ = 0.59). In 30 patients CT was equivocal with cancer in 14 and benign disease in 16. PET correctly diagnosed 13 of these patients (cancer in 6 and benign disease in 7), interpreted 4 as equivocal (cancer in 3 and benign disease in 1) but was incorrect in the remaining 13 patients (cancer in 5 and benign disease in 8). The sensitivity and specificity for detecting small volume metastatic disease were 20 and 94% for CT and 22 and 91% for PET, respectively. Conclusion: PET had a similar accuracy to that of CT for imaging pancreatic cancer but it did not provide any additional information in patients with equivocal CT findings and currently would seem of little benefit for the staging of pancreatic cancer.

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“…Several authors have demonstrated that laparoscopy is both safe and feasible to better assess resectability in pancreatic cancer patients before resorting to an open resective procedure, especially when associated with laparoscopic ultrasound [12,13,14,15,16,17,18]. Moreover, other authors have reported that such an approach can be adopted on a routine basis [19,20,21,22,23].…”

Section: Discussionmentioning

confidence: 99%

“…The role of laparoscopy and laparoscopic US in staging pancreatic cancer is well established [12,13,14,15,16,17,18], and the procedure is considered routine before exploratory laparotomy for pancreatic resection by several high-volume centers [19,20,21,22,23]. …”

Section: Introductionmentioning

confidence: 99%

The Role of Laparoscopy in Advanced Pancreatic Cancer Diagnosis

et al. 2007

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Background/Aims: Histological diagnosis between ductal and endocrine carcinoma is imperative in patients with advanced and unresectable pancreatic malignancies because of the different treatment modalities and prognoses. Whenever percutaneous and endoscopic ultrasound-guided pancreatic fine needle aspiration (FNA) fails to obtain a diagnostic specimen, a laparoscopic approach may be employed. Methods: Between October 2002 and July 2004, 19 patients with demonstrated unresectable pancreatic cancer underwent laparoscopy to obtain a cytohistological diagnosis. Results: The mean operative time was 83 min. Laparoscopy showed the presence of liver metastases in 15 patients that were correctly diagnosed by preoperative imaging in only 8 cases (53%). Overall 5 pancreatic FNA and 16 liver and peritoneal biopsies were obtained. In 1 patient the procedure was abandoned due to hypercapnia. In 16 patients (84%) a cytohistological diagnosis was obtained. There were no mortalities. Conclusions: Laparoscopic biopsy of advanced unresectable pancreatic cancer is a feasible, safe and reliable procedure to obtain a cytohistological diagnosis whenever ultrasound-guided FNA fails.

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Is There Additional Information from Laparoscopic Ultrasound in Tumor Staging?

Cited by 21 publications

References 23 publications

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Positron Emission Tomography Does Not Add to Computed Tomography for the Diagnosis and Staging of Pancreatic Cancer

The Role of Laparoscopy in Advanced Pancreatic Cancer Diagnosis

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