Role of laparoscopy in the staging of gastrointestinal cancer

Accurate staging plays a primary role in determining the appropriate treatment of gastrointestinal malignancies. Recently, laparoscopy has emerged as a staging modality that is more sensitive and specific in staging most gastrointestinal cancers than preoperative imaging modalities. The addition of laparoscopic ultrasonographic techniques has achieved even greater staging accuracy. Consequently, patients with disease that is amenable to resection are better identified, and others with locally advanced disease are spared unnecessary laparotomies. Since laparoscopic techniques may be associated with low morbidity and a rapid recovery, palliative procedures are being developed for patients with advanced gastrointestinal malignancies. This reviews summarizes the current status of laparoscopic staging of gastrointestinal malignancies and compares this technique to preoperative imaging modalities. Also discussed are promising staging technologies and therapeutic procedures that may soon play an important role in the management of gastrointestinal cancer patients.