This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Combined preoperative endoscopic and laparoscopic ultrasonography for prediction of R0 resection in upper gastrointestinal tract cancer. BJS 2006; 93: 720-725.
Published: 2nd May 2006
Authors: M. B. Mortensen, C. W. Fristrup, A. P. Ainsworth, T. Pless, H. O. Nielsen, C. Hovendal et al.
Background
This study evaluated the ability of combined endoscopic and laparoscopic ultrasonography to predict R0 resection and avoid unnecessary surgery in patients with upper gastrointestinal tract cancer (UGIC).
Method
A total of 411 consecutive patients with UGIC (182 pancreatic cancers, 134 gastric cancers and 95 oesophageal cancers) treated between January 2002 and May 2004 were analysed prospectively. The allocation of patients into resectability groups by endoscopic ultrasonography (EUS) and laparoscopic ultrasonography (LUS) was compared with the treatment actually undertaken.
Results
The combination of EUS and LUS correctly predicted R0 resection in 90·6 per cent, R1–R2 in 91 per cent and irresectability in 91·4 per cent of patients. Ten patients (2·4 per cent) had explorative laparotomy only. There were no complications associated with the EUS and LUS procedures.
Conclusion
The routine use of EUS and LUS before surgery predicted R0 resection in nine of ten patients and reduced the number of unnecessary laparotomies to less than 3 per cent. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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