Diagnostic Laparoscopy in Digestive Cancers: Is it Useful?The Experience of a Third World Low-Volume Institute After 70 Consecutives Cases

Aim of the Study: Despite the availability of high quality imaging modalities, 25-40% of patients who underwent a laparotomy for digestive cancer could not be resected, with non-resectability identified only during laparotomy. This prevalence is higher in developing countries due to lack of adequate radiographic devices. This study was undertaken to assess the value of diagnostic laparoscopy in the management of digestive cancers in Cameroon, a poor setting. Patients and Methods: From January 2010 to January 2016, a consecutive cohort of patients with gastro-intestinal tract malignancies who had undergone a diagnostic laparoscopy at our institution was queried prospectively. Results: A total of 70 procedures were recorded among whom 25 (35.71%) diagnostic laparoscopy (DL), 5(7.14%) staging laparoscopy (SL) and 40 (57.15%) laparoscopy first (LF). During DL, 44% of the suspected preoperative organ wasn’t confirmed and the diagnosis was finally benign in 36.36%. After SL, the radiographic staging wasn’t confirmed in 60% of the cases. During LF, contra-indications of curative surgery were found in 20% and 62.5% of patients eligible to resection were managed through laparoscopy-assisted approach with a morbidity rate of 5.2%. Conclusion: The present analysis supports the useful of diagnostic laparoscopy in the management of patients with digestive cancers in a developing country.