ArticleChirurgie (Heidelberg, Germany)2026
[Diagnostic laparoscopy for peritoneal carcinomatosis-Why repeat laparoscopy often remains indispensable].
Article in Chirurgie (Heidelberg, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPeritoneal carcinomatosis (PC) remains associated with a poor prognosis; however, for selected patients, cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can provide a potentially curative approach if complete cytoreduction (CCR) can be achieved. Diagnostic laparoscopy (LSK) is the key tool for selecting appropriate patients.
objectiveThe aim of this study was to evaluate the informational quality of externally performed diagnostic LSK in patients with PC with respect to making decisions on CRS and HIPEC. MATERIAL AND
methodsIn this prospective single-center observational study, 42 patients with PC and potentially achievable CCR were included. Original operative reports from external LSK were obtained. If external LSK was inconclusive, repeat laparoscopy was performed. The findings from external laparoscopies were compared with those obtained from laparoscopies performed at our center.
resultsPrior operative staging had been performed externally in 30/42 patients. The peritoneal cancer index (PCI) was documented in only 11.4% of cases. Photographic documentation was available in 22.9% of cases. In most reports no information was provided on small bowel involvement, Douglas pouch involvement or other critical tumor locations. In contrast, in-house LSK documented the PCI in 97.5% of cases and included photographic documentation in 77.5%.
conclusionInadequate assessment and documentation of laparoscopies performed externally for the evaluation of PC generally does not enable reliable decision-making regarding CRS and HIPEC. Standardized reporting protocols developed in collaboration with CRS centers are needed. Until then, repeat LSK remains essential to avoid overtreatment and undertreatment.
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