title: Staging laparoscopy in advanced gastric cancer: usefulness and issues requiring improvement.
abstract: OBJECTIVE
  We performed staging laparoscopy (SL) for advanced gastric cancer with suspicion of positive peritoneal cytology (CY) or peritoneal metastasis (P). This study was designed to show SL's utility in advanced gastric cancer.
  
  
  METHODS
  This was a retrospective study of 124 patients with primary gastric cancer who underwent SL between October 2001 and March 2009.
  
  
  RESULTS
  There were no perioperative complications without a case of bleeding. The patient breakdown was P0CY0, 67; P0CY1, 19; P1CY0, 6; and P1CY1, 32. Chemotherapy was administered as the initial treatment in 33 patients and the period from SL to chemotherapy was 19.5 days. In 7 patients undergoing laparotomy as the initial treatment but later requiring exploratory laparotomy or palliative surgery followed by chemotherapy, the period from laparotomy to chemotherapy was 36.8 days. The difference was significant (p<0.0001). P1 was confirmed in 10 (14.5%) of 69 patients undergoing laparotomy as the initial treatment. CY was re-examined in 53 of these 69 patients and CY1 was confirmed in 6 (13.3%) of 45 patients who were CY0 according to SL.
  
  
  CONCLUSIONS
  With SL, early initiation of chemotherapy was possible for P1 patients. Although improved accuracy is required, SL, which can be carried out safely with minimal invasiveness, was suggested to be useful.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Yamagata
authors.forename: Katsumi
authors.initials: K
authors.lastname: Amikura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kawashima
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Yatsuoka
authors.forename: Yoji
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Seto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000556:secondary; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome