The overall prognosis for patients with esophageal cancer is poor. Many patients with esophageal cancer present at an advanced stage with lymph node or even distant metastases. Patients with advanced cancer commonly undergo preoperative chemotherapy and radiation in an attempt to improve survival. Thus, the value of precise staging is important to separate patients with an early stage tumor who are candidates for immediate curative resection from those who need neoadjuvant therapy. The most common radiologic tests used to confirm the stage of the tumor are CT scan, endoscopic ultrasound, and PET scan. Staging laparoscopy may aid in more accurate staging of esophageal cancers to guide the most appropriate treatment and avoid non-therapeutic laparotomy.
Staging laparoscopy should be used for patients with esophageal cancer who are potential candidates for curative surgical resection based on a negative preoperative staging for lymph node or distant metastases. Furthermore, the procedure can be used for the placement of enteral feeding access in patients when a percutaneous endoscopic gastrostomy cannot be undertaken, and the patients are candidates for neoadjuvant chemotherapy.
The primary contraindication is known metastatic disease. In addition, dense intra-abdominal adhesions, particularly in the upper abdomen, from prior surgery may be a relative contraindication.
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