Influence of laparoscopic gastrectomy on the detection rate of free gastric cancer cells in the peritoneal cavity.

Ann Surg Oncol

Department of General Surgery and Center of Minimally Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China.

Published: January 2010

Background: Whether laparoscopic gastrectomy affects the number of gastric cancer cells exfoliated from the cancer-invaded serosa remains unclear. This study aimed to compare the detection rate of free gastric cancer cells in the peritoneal cavity during laparoscopic and open gastrectomy.

Methods: Intraoperative peritoneal washings were collected from 83 gastric cancer patients undergoing laparoscopic gastrectomy and 81 patients undergoing open surgery. Hematoxylin and eosin (H&E) staining and real-time reverse-transcription polymerase chain reaction (RT-PCR) were used to examine the free cancer cells.

Results: The postoperative positive rates of free cancer cells detected by cytological and real-time RT-PCR were 39.76 and 43.20% in the laparoscopic and open groups, respectively. Depth of tumor invasion, area of invaded serosa, regional lymph node involvement, and higher pathological staging were significantly associated with presence of free cancer cells.

Conclusion: The laparoscopic techniques used in gastric cancer surgery did not increase the detection rate of free cancer cells in the peritoneal cavity compared with conventional techniques.

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http://dx.doi.org/10.1245/s10434-009-0703-2DOI Listing

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