Background: Diagnostic laparoscopy has been used to determine resectability
and to prevent unnecessary laparotomy in patients with advanced esophageal
cancer. The objective of this prospective study was to evaluate the role o
f laparoscopy in conjunction with computed tomography (CT) scan in staging
patients with esophageal cancer.
Methods: From March 1995 to October 1998, 59 patients with biopsy-proven es
ophageal cancer underwent diagnostic laparoscopy with concurrent vascular a
ccess device and feeding jejunostomy tube placement.
Results: Laparoscopy changed the treatment plan in 10 of 59 patients (17%).
Of the patients with normal-appearing regional or celiac nodes, 78% were c
onfirmed by biopsy to be tumor free, whereas 76% of patients with abnormal-
appearing nodes were confirmed by biopsy to have node-positive disease.
Conclusions: Diagnostic laparoscopy is useful for detecting and confirming
nodal involvement and distant metastatic disease that potentially would alt
er treatment and prognosis in patients with esophageal cancer.