Minilaparoscopy in the diagnosis of peritoneal tumor spread: prospective controlled comparison with computed tomography.
BACKGROUND
Early diagnosis of peritoneal spread in malignant disease prevents unnecessary laparotomies. Minimally invasive laparoscopy with the patient under conscious sedation is a new, easily feasible diagnostic technique. This study compares prospective and controlled diagnostic minilaparoscopy with computed tomography (CT) scan for the diagnosis of peritoneal metastases.


METHODS
In this study, 56 patients with malignant disease were prospectively investigated with diagnostic minilaparoscopy and CT scan.


RESULTS
The study criteria were fulfilled by 54 patients. Minilaparoscopy detected peritoneal carcinosis in 28 of 54 cases, whereas CT detected the disease in 14 of 54 cases. For 36 patients, the diagnosis could be verified by histologic examination of peritoneal biopsies or laparotomy. In this group, minilaparoscopy detected peritoneal carcinosis in 25 of 36 cases, whereas CT detected the disease in 12 of 36 cases.


CONCLUSIONS
Minilaparoscopy was more sensitive than CT in detecting peritoneal carcinosis (100% vs 47.8%; p < 0.01). Considering its low grade of invasiveness and superior sensitivity, minilaparoscopy should be regarded as the procedure of choice for the early detection of peritoneal carcinosis.
Denzer
U
U
Department of Medicine, Johannes Gutenberg University, Langenbeckstrasse 1, D-55131, Mainz, Germany. denzer@mail.uni-mainz.de
Hoffmann
S
S
Helmreich-Becker
I
I
Kauczor
H U
HU
Thelen
M
M
Kanzler
S
S
Galle
P R
PR
Lohse
A W
AW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary*; D016292:Procedural Sedation; D004067:Digestive System Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010051:Ovarian Neoplasms / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed