Laparoscopic management of cancer patients.
All the reported experience indicates that laparoscopic staging of tumours provides additional information to the preoperative work-up. Its diagnostic yield is enhanced by contact ultrasonography. Staging laparoscopy may avoid needless laparotomy and permits palliative surgical treatment, bypass and resection. The major controversy concerns laparoscopic ablative procedure for potentially curative cancer in view of the potential but unproved risk of tumour dissemination and inadequate resection. Until further information becomes available from experimental investigations and centralized clinical studies, laparoscopic curative resections should not be performed routinely. Laparoscopic or retroperitoneoscopic lymphadenectomy appears to be useful by documenting node positive disease. Laparoscopic hepatic cryotherapy with insulated needle probes has the potential for control of secondary hepatic disease not amenable to surgical resection.
Cuschieri
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Department of Surgery, Ninewells Hospital and Medical School, Dundee, UK.
D001661:Biliary Tract Neoplasms / Q000473:pathology / Q000601:surgery; D001706:Biopsy; D017679:Cryotherapy; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery; D008197:Lymph Node Excision; D009366:Neoplasm Seeding; D009369:Neoplasms / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D010166:Palliative Care