OGC SO20 - Audit of the guidelines for staging laparoscopy in gastro-oesophageal cancers

Abstract

Abstract Background Staging laparoscopy and peritoneal washings form part of surgical work up of oesopheageal and gastric cancers. Peritoneal washings help to identify microscopic disease, the presence of which drastically alters prognosis. This audit looks at the adherence to staging laparoscopy guidelines introduced, and the intraoperative finding. Method Staging laparoscopy and peritoneal washings form part of surgical work up of oesophageal and gastric cancers. Peritoneal washings help to identify microscopic disease, the presence of which drastically alters prognosis. This audit looks at the adherence to staging laparoscopy guidelines introduced, and the intraoperative finding. Results Two hundred and twenty-seven patients were identified. Two patients did not have washings performed due to the extent of their disease, which was appropriate. The remaining patients had washings performed. Twelve patients had washings performed but not in line with policy. In all cases a clinical reason was found. Overall twelve patients had positive cytology from the washings. Of those that had washings, forty-one patient’s had T1/T2 disease and one hundred and eight-four patients had T3/T4 disease. All cytology positive patients had T3/T4 stage disease. Conclusion Two hundred and twenty-seven patients were identified. Two patients did not have washings performed due to the extent of their disease, which was appropriate. The remaining patients had washings performed. Twelve patients had washings performed but not in line with policy. In all cases a clinical reason was found. Overall twelve patients had positive cytology from the washings. Of those that had washings, forty-one patient’s had T1/T2 disease and one hundred and eight-four patients had T3/T4 disease. All cytology positive patients had T3/T4 stage disease