title: Role of laparoscopic ultrasonography in the management of patients with oesophagogastric cancer.
abstract: BACKGROUND
  Laparoscopy and laparoscopic ultrasonography (lapUS) have been shown to improve the staging of patients with oesophagogastric cancer but there remains doubt as to whether most benefit follows laparoscopy alone and how much is contributed by the addition of lapUS.
  
  
  METHODS
  The role of lapUS in surgical decision making was evaluated prospectively in a consecutive series of patients with oesophagogastric cancer following conventional radiological assessment. The results of the lapUS findings over and above the laparoscopic findings were documented in order to identify the additional benefit of lapUS.
  
  
  RESULTS
  After initial conventional assessment 41 patients were considered unsuitable for surgery and treated by palliation, with a further 25 patients proceeding to surgery without laparoscopy. Of the 93 patients who underwent laparoscopy, 18 were shown to have irresectable disease and avoided further surgery; a further seven avoided inappropriate surgery by the addition of lapUS. The open-close laparotomy rate was reduced from five of 25 in patients who did not undergo laparoscopy to nine (12 per cent) of 75 by the introduction of laparoscopy and to two (3 per cent) of 68 with the addition of lapUS.
  
  
  CONCLUSIONS
  Laparoscopy alone prevented unnecessary surgery in 18 (19 per cent) of 93 patients with oesophagogastric cancer and the addition of lapUS identified a further seven patients (8 per cent) in whom unnecessary surgery was avoided.
authors.affiliation: University Department of Surgery, Royal Infirmary, Edinburgh EH3 9YW, UK.
authors.forename: A
authors.initials: A
authors.lastname: Smith
authors.forename: M D
authors.initials: MD
authors.lastname: Finch
authors.forename: T G
authors.initials: TG
authors.lastname: John
authors.forename: O J
authors.initials: OJ
authors.lastname: Garden
authors.forename: S P
authors.initials: SP
authors.lastname: Brown
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D003657:Decision Making; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D018084:Ultrasonography, Interventional