Laparoscopy significantly improves the perceived preoperative stage of gastric cancer.
Laparoscopy significantly improves the perceived preoperative stage of gastric cancer.
复制标题
DOI：
10.1007/s10120-003-0257-0
复制
发表时间：
2003-01-01
期刊：
影响因子：
--
通讯作者：
Lewis, Wyn G
中科院分区：
文献类型：
--
作者：
Blackshaw, Guy R J C;Barry, Jonathan D;Lewis, Wyn G
背景：本研究的目的是通过与术前计算机体层摄影(CT)检查比较，检验腹腔镜术对胃癌患者分期的准确性。方法：在连续的258例胃腺癌患者中，100例患者行术前CT分期，然后行分期腹腔镜术。结果：CT分期与最终病理分期的符合程度T期为Kw=0.336(95%可信区间；0.172~0.50；P=0.0001)，M期为0.378(95%CI；0.226~0.53；P=0.0001)，而T期为0.455(95%CI；0.301~0.609；P=0.0001)；P=0.0001)和0.73(95%CI；0.596~0.864；P=0.0001)。21例患者在腹腔镜术中发现了CT未发现的可疑转移，所有患者的CT均显示为T3或T4局部进展期肿瘤。结论：在CT无转移的情况下，胃癌术前腹腔镜分期是潜在的局部进展性疾病的手术候选对象。本研究的目的是通过与术前计算机体层摄影(CT)检查的比较，检验腹腔镜术在胃癌患者分期中的准确性。
BACKGROUND: The aim of this study was to examine the accuracy of laparoscopy is staging patients with gastric cancer in comparison with preoperative computed tomography (CT) examination.METHODS: One hundred patients out of a consecutive series of 258 patients with gastric adenocarcinoma underwent a preoperative staging CT followed by a staging laparoscopy. The strengths of the agreement between the CT stage, the laparoscopic stage, and the final histopathological stage were determined by the weighted Kappa statistic (Kw).RESULTS: The strengths of agreement between the CT stage and the final histopathological stage were Kw = 0.336 (95% confidence interval [CI]; 0.172-0.5; P = 0.0001) for T stage and 0.378 (95% CI; 0.226-0.53; P = 0.0001) for M stage, compared with 0.455 (95% CI; 0.301-0.609; P = 0.0001) and 0.73 (95% CI; 0.596-0.864; P = 0.0001) for the laparoscopic T and M stages, respectively. Unsuspected metastases that were not detected by CT, were found in 21 patients at laparoscopy, all of whom had T3 or T4 locally advanced tumors evident on CT.CONCLUSIONS: Preoperative laparoscopic staging of gastric cancer is indicated for potential surgical candidates with locally advanced disease in the absence of metastases on CT. The aim of this study was to examine the accuracy of laparoscopy in staging patients with gastric cancer in comparison with preoperative computed tomography (CT) examination.