Gastric cancer very often presents with locally advanced or metastatic disease. Accurate staging of gastric cancer aids in the appropriate treatment selection for both cure and palliation. Palliative resection may be indicated for gastric cancer causing obstruction, hemorrhage, or perforation; however, surgical resection alone for patients with advanced disease has not been shown to improve survival. Studies regarding neoadjuvant protocols for locally advanced gastric cancers are ongoing which makes accurate staging imperative. Moreover, even after many preoperative radiologic tests (CT scan, endoscopic and transabdominal ultrasound, and PET scan) for staging of gastric tumors, a proportion of patients are found to have unsuspected, unresectable disease at exploration. Thus, staging laparoscopy may aid in the more accurate staging of gastric cancers and guide appropriate treatment without the morbidity associated with exploratory laparotomy.
Reasoning For Staging Laparoscopy
Patients with T3 or T4 gastric cancer without evidence of lymph node or distant metastases on high quality preoperative imaging
Severe upper abdominal adhesions from prior surgery that may preclude the procedure
Details On Gastric Cancer Surgery
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