| Theme | Laparoscopic and Endoscopic Therapy for Digestive Organ | |
|---|---|---|
| Title | Laparoscopic Surgery for Carcinoma of Digestive Organ-Indication, Outcomes, Problems and its Future | |
| Publish Date | 1999/02 | |
| Author | Tatsuo Yamakawa | Department of Surgery, University Hospital at Mizonokuchi Teikyo University School of Medicine |
| [ Summary ] | With the advent of technologies and instrumentation. Laparoscopic surgery has become a common procedure for the surgical management of various diseases. However its use for management of carcinoma of the gastrointestinal tract is still controversial, probably due to the problems inherent to this procedure such as technical limitation, port site recurrence and so on. Considering the data reviewed in this paper, however, it is safe to say that although the mechanism implicated in the implantation of tumors on the port sltes remain uncertain, but the extraction site appears to be a risk for abdominal metastases. Future research should focus on the role of tumor biology, local environment, alternative gases, gasless surgery and surgical skill in the prevention of port site recurrence. On the other hand, it is also true that endoscopic surgery is a technique which should be placed at the site between endoscopic mucosal resection and radial open surgery, because of some of its technical limitations is lymphnodes dissection. Its indication should be also limited only for those patients with early stage carcinoma to make the incidence of incisional recurrence at a level comparable with that seen in open Surgery. Moreover, surgeons must be well versed in the fundamental technologies of laparoscopic cancer surgery. |
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