Determine the relationship of preoperative Endoscopic Ultrasound (EUS) scan staging in gastric adenocarcinoma patients with parietal peritoneal involvement in laparoscopy, 2012-16

Background and Objective: Application of correct device with high diagnosis rate provides useful pre-surgery information. In this study we assess correlation of preoperative Endoscopic Ultrasound (EUS) scan staging in gastric adenocarcinoma with parietal peritoneal involvement in laparoscopy in patients with peritoneal involvement that should be received only chemotherapy.Materials and Methods: This analytical cross sectional study was performed on 117 patients with gastric adenocarcinoma using convenience sampling method whom referred to the Firoozgar Hospital, Tehran, Iran during the 2012-16. Inclusion criteria for the study of stomach cancer by endoscopy and biopsy confirmed and chemotherapy are planned. Exclusion criteria was patients in whom laparoscopy high risk of cardiovascular and respiratory disease and a history of previous laparotomy. EUS was performed by a gastroenterologist. Using this method, the stomach ulcer based on the tumor location (cardia, body and antrum) and stage of tumor (from IIA to IV) were determined. In addition to performing laparoscopy, taking biopsy was done. Quantitative data as age was expressed as mean (±SD) and gender was reported as percentage. Analysis test used in this study was Chi2 to compare categorical variables, it was performed using SPSS Software version 22 (Chicago, IL, USA) and level of significance was considered <0.05. Also this study has been approved by the ethical committee of Iran University of Medical Sciences. Findings: In the total of 117 patients included in this study, mean age (±SD) was 60 ± 13 in the range of 25-83 years old. 84 (78.1%) of patients were male and 33 (28.2%) of patients were female. Pathologic results of adenocarcinoma in the patients showed 60.7% of the patients were Signet ring cell type in pathology while 39.3% were intestinal cell type. 33 (28.2%) of patients had peritoneal involvement. Also peritoneal involvement frequencies and difference in cardia, body and antrum cancer based on the EUS were 6.8%, 12.8% and 8.5% respectively (P=0.556).Percentages and differences in parietal peritoneal involvement, based on EUS staging in these 33 patients, were 0% in stage IB, 25% in stage IIA, 29.6% in stage IIB, 38.1% in stage IIIA, 22.2% in stage IIIB, 30% in stage IIIC and 38.5% in stage IV (P=0.541). Conclusion: It attempted to suggest application of the EUS scan and laparoscopy use with chemotherapy for gastrointestinal tract malignancies can be useful and patient with peritoneal involvement in laparoscopy omitted for laparotomy. But prospective studies are suggested to investigate.

کلیدواژه ها:

Upper Gastrointestinal Tract Malignancies ، Endoscopic Ultrasound (EUS) ، laparoscopy ، Parietal Peritoneal Involvement ، Gastric Adenocarcinoma