Impact of laparoscopy and ultrasonography in gastrointestinal malignancies.
OBJECTIVE
An adequate preoperative disease staging is highly required before surgical treatment, even in gastrointestinal malignancies. Our study wants to give a contribution in order to define echolaparoscopy weight in gastrointestinal tumors and its impact in surgical therapy.


METHODS
33 patients were affected by pancreas, 22 by stomach, 16 by extrahepatic biliary tract and 18 by liver cancers; every patient was considered worthy of radical or palliative surgery according to preoperative staging (thorax-abdominal CT and percutaneous ultrasonography). Paired sample t-tests were used to analyze the results of each methodical and probability values of less than 0.05 were considered significant.


RESULTS
Preoperative instrumental examinations gave correct evaluations only in 44 of 89 cases (49%) while echolaparoscopic gave correct evaluations in 82 on 89 cases (92%) (P<0.05). So after echolaparoscopic in only 7 cases we performed an explorative laparotomy.


CONCLUSIONS
Laparoscopy and ultrasound impact on therapy is worthy of attention. It seems to be able to give advantages in staging gastrointestinal malignancies, except for pancreas cancers, in which some limits and negative aspects have been demonstrated, regarding the possibility of giving correct diagnosis of portal axis infiltration.
Carrella
G
G
University of Ferrara, Department of Surgical, Anesthesiological and Radiological Sciences Section of General Surgery, Universita di Ferrara, Italy.
Sortini
D
D
Basaglia
E
E
Marcello
D
D
Carcoforo
P
P
Sortini
A
A
Pozza
E
E
D004067:Digestive System Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D019160:Endosonography; D006801:Humans; D010535:Laparoscopy; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D015203:Reproducibility of Results; D018615:Ultrasonography, Doppler, Color