Incorporation of diagnostic laparoscopy in the management algorithm for patients with peritoneal metastases: A multi‐institutional analysis. Issue 8 (3rd June 2015)

• Record Type: Journal Article
• Authors: Tabrizian, Parissa; Jayakrishnan, Thejus T.; Zacharias, Anthony; Aycart, Samantha; Johnston, Fabian M.; Sarpel, Umut; Labow, Daniel M.; Turaga, Kiran K.
• Is Part Of: Journal of surgical oncology. Volume 111:Issue 8(2015:Jun. 15)
• Page Start: 1035
• Page End: 1040
• Publication Date: 2015-06-03
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23924
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso23924-sec-0001" sec-type="section"> <title>Introduction</title> <p>Diagnostic laparoscopy (DL), which can predict complete cytoreduction (CC), is often considered unfeasible in patients with Peritoneal metastases (PM) due to a hostile abdomen, prior surgeries, incomplete assessment or risk of port site recurrence. We hypothesized that DL can be successfully incorporated into the management of patients with PM.</p> </sec> <sec id="jso23924-sec-0002" sec-type="section"> <title>Methods</title> <p>Retrospective review and data analysis of prospectively maintained databases from two high volume institutions was performed between 2007 and 2013.</p> </sec> <sec id="jso23924-sec-0003" sec-type="section"> <title>Results</title> <p>DL was successfully completed in 211/217 (92.6%) patients with PM. The technique for entry was the Hasson in 57%, optical trocar in 38% and Veress needle in 5%. Serosal injury from DL occurred in one patient (0.4%). Predominant histology included appendiceal (40%) and colorectal primaries (34%). Exclusion from cytoreduction by DL occurred in 68 (31.3%). Among those excluded, 7 (of 68, 10.3%) subsequently underwent CRS + HIPEC after receiving systemic chemotherapy. Overall survival (from laparoscopy) for those that underwent CRS + HIPEC at the original operation was 36 versus 12.7 months among those who were excluded by laparoscopy. There were no cases of port site recurrence.</p> </sec> <sec id="jso23924-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Diagnostic laparoscopy can be safely incorporated in the management of patients with peritoneal metastases, and can be especially beneficial in excluding patients from attempted incomplete cytoreduction. <italic>J. Surg. Oncol. 2015 111:1035–1040</italic>. © 2015 Wiley Periodicals, Inc.</p> </sec> </abstract>