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Laparoscopy enabled detection of inoperable disease in 92 patients (38 per cent), several of whom had more than one contraindication to surgery. Hepatic metastases (n = 75, 31 per cent), extensive peritoneal (n = 25, 10 per cent) or lymph node involvement (n =5, 2 per cent) and direct invasion of the liver or colon (n = 5, 2 per cent) were considered contraindications to surgery. Laparoscopy was poorly tolerated in a further 11 (5 per cent) patients, who were not considered suitable for resection. Extra- abdominal metastatic disease was detected in 17 patients who appeared normal at laparoscopy, and a further six patients refused surgery. The remaining 118 patients underwent laparotomy with a view to resection which was successful in 85 (72 per cent). Laparoscopy thus prevented ill-advised laparotomy in 103 patients (42 per cent), either because of extensive intra-abdominal disease or poor tolerance to anaesthesia. Laparoscopy may be a valuable investigation when used to assess the feasibility of resection.<\/jats:p>","DOI":"10.1002\/bjs.1800820322","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T21:36:09Z","timestamp":1172957769000},"page":"352-354","source":"Crossref","is-referenced-by-count":75,"title":["Laparoscopy in the management of patients with cancer of the gastric cardia and oesophagus"],"prefix":"10.1093","volume":"82","author":[{"given":"R G","family":"Molloy","sequence":"first","affiliation":[{"name":"University Department of Surgery, The Royal Infirmary , Glasgow,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J S","family":"McCourtney","sequence":"additional","affiliation":[{"name":"University Department of Surgery, The Royal Infirmary , Glasgow,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J R","family":"Anderson","sequence":"additional","affiliation":[{"name":"University Department of Surgery, The Royal Infirmary , Glasgow,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1995,3,1]]},"reference":[{"key":"2024092814364031100_bib1","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/S0140-6736(70)92125-2","article-title":"Benefits and hazards of laparotomy for medical patients","volume":"ii","author":"Scott","year":"1970","journal-title":"Lancet"},{"key":"2024092814364031100_bib2","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1002\/1097-0142(197803)41:3<941::AID-CNCR2820410323>3.0.CO;2-M","article-title":"Adenocarcinoma of the stomach: review of 1497 cases","volume":"41","author":"Dupont","year":"1978","journal-title":"Cancer"},{"key":"2024092814364031100_bib3","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S0022-5223(19)35385-1","article-title":"Selective therapeutic approach to cancer of the lower esophagus and cardia","volume":"95","author":"DeMeester","year":"1988","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024092814364031100_bib4","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0022-5223(19)37001-1","article-title":"Risk stratification and long-term results after surgical treatment of carcinomas of the thoracic esophagus and cardia. 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