ABSTRACT
BACKGROUND: port-site metastases (PSM) have been reported following oncological laparoscopic surgery. However, their frequency after laparoscopic examination in gastric cancer has not been well established. MATERIAL AND METHODS: prospective follow-up of 41 patients having had a staging laparoscopy and a follow-up longer than 12 months. Mean age was 65 years (29-89). After staging, an open gastrectomy was performed in 33 cases. Mean follow-up was 21.4 (12-66) months. PSM was defined as a node in the former port-site wound with adenocarcinoma histology at biopsy. RESULTS: no patient showed clinical signs of PSM or port-site recurrence, even in advanced stages. We had no morbidity or postoperative mortality attributable to laparoscopic manoeuvres, and no need for laparotomy in cases without a gastrectomy indication. CONCLUSIONS: our results suggest that staging laparoscopy is a safe procedure in gastric carcinoma, as it is not associated with PSM after even considerable follow-up, and has a very low complication rate.
Subject(s)
Carcinoma/pathology , Laparoscopy , Neoplasm Staging/methods , Stomach Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Carcinoma/mortality , Carcinoma/surgery , Female , Follow-Up Studies , Gastrectomy , Humans , Male , Middle Aged , Neoplasm Seeding , Postoperative Complications , Prospective Studies , Stomach Neoplasms/mortality , Stomach Neoplasms/surgery , Survival RateABSTRACT
Introducción: se han descrito metástasis en puertos laparoscópicostras cirugía laparoscópica oncológica. Sin embargo, lafrecuencia tras los procedimientos laparoscópicos en el carcinomagástrico es poco conocida.Material y métodos: se realizó un estudio prospectivo de 41pacientes a quienes se había realizado laparoscopia de estadificación,con un seguimiento postoperatorio mayor de un año. Laedad media era de 65 años (29-89). Tras la estadificación, se realizógastrectomía abierta en 33 pacientes. El seguimiento mediofue de 22,4 meses (12-66). La metástasis en los orificios de trócaresse definió como un nódulo en la cicatriz de la puerta laparoscópicacon biopsia de adenocarcinoma.Resultados: ningún paciente presentó metástasis clínicas enlos orificios de trócares de laparoscopia, incluso en estadios avanzados.No evidenciamos morbilidad ni mortalidad postoperatoriaatribuible a las maniobras laparoscópicas ni necesidad de laparotomíaen pacientes sin indicación de gastrectomía.Conclusiones: nuestros resultados sugieren que la laparoscopiade estadificación en el carcinoma gástrico es un procedimientoseguro ya que no se asocia a metástasis en los orificios de trócartras un seguimiento considerable, y tiene una baja frecuencia decomplicaciones
Background: port-site metastases (PSM) have been reportedfollowing oncological laparoscopic surgery. However, their frequencyafter laparoscopic examination in gastric cancer has notbeen well established.Material and methods: prospective follow-up of 41 patientshaving had a staging laparoscopy and a follow-up longer than12 months. Mean age was 65 years (29-89). After staging, an opengastrectomy was performed in 33 cases. Mean follow-up was21.4 (12-66) months. PSM was defined as a node in the former portsitewound with adenocarcinoma histology at biopsy.Results: no patient showed clinical signs of PSM or port-siterecurrence, even in advanced stages. We had no morbidity orpostoperative mortality attributable to laparoscopic manoeuvres,and no need for laparotomy in cases without a gastrectomy indication.Conclusions: our results suggest that staging laparoscopy is asafe procedure in gastric carcinoma, as it is not associated withPSM after even considerable follow-up, and has a very low complicationrate
