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腹腔镜已用作腹腔内恶性肿瘤分期的重要诊断工具,但在胃癌的应用中存有不同的看法,赞成者认为腹腔镜检查可以正确分期以俾避免不必要的探查手术。在术前检查中,已用腹腔B超扫描、肝闪烁扫描和CT扫描检查方法,其中以CT扫描的价值较大。为此,作者在应用新一代CT扫描仪时代评估腹腔镜检查在胃癌分期中的价值。自1991～1995年取71例组织学确诊为胃腺癌病例进行腹腔镜分期。根据腹部CT和体格检查均认为肿瘤是可以切除的,即属T1～4、NO～2、MO期。均作腹腔镜检查,观察腹膜面、肝和大网膜,自1993年以后还自网膜开窗常规检查小网膜孔。凡拟作辅助化疗以及伴转移病灶者在腹腔镜下作空肠饲管置入术,腹腔镜检的结果均以病理组织学为准。
Laparoscopy has been used as an important diagnostic tool for the staging of intra-abdominal malignancies, but there are different views in the application of gastric cancer, and those in favor believe that laparoscopy can be staged correctly to avoid unnecessary probing operations. In the preoperative examination, abdominal ultrasound scanning, hepatic scintigraphy, and CT scans have been used, of which the value of CT scanning is relatively large. To this end, the authors evaluated the value of laparoscopy in the staging of gastric cancer in the era of applying a new generation of CT scanners. From 1991 to 1995, 71 cases of histologically diagnosed gastric adenocarcinoma were selected for laparoscopic staging. According to abdomen CT and physical examination, the tumor is considered to be resectable, that is, T1 ~ 4, NO ~ 2, MO phase. Laparoscopy was performed to observe the peritoneal surface, liver, and omentum, and the small omentum holes were routinely inspected from the omentum after 1993. All patients scheduled for adjuvant chemotherapy and metastatic lesions underwent laparoscopic enteral feeding tube insertion. The results of laparoscopy were based on histopathology.