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At least 19 recordsLinked to original sources
PubMed1981

Peritoneoscopy in the management of ovarian cancer.

The results obtained from the routine use of peritoneoscopy in the initial evaluation and follow-up of 99 patients with ovarian cancer treated at the National Cancer Institute between 1970 and 1978 have been analyzed. Prior to treatment, peritoneoscopy documented new sites of involvement undetected by conventional radiologic and isotopic procedures in 42 patients (48%) and provided the only evidence for follow-up of disease in 25 patients (28%). Twenty-one percent of patients referred with Stages I and II disease were upstaged to Stage III on the basis of diaphragmatic disease detected at peritoneoscopy. In the 66 restaging (posttreatment) peritoneoscopies, residual disease was found in 33 (50%) and peritoneoscopic findings provided the only evidence for disease in 24 cases (36%). These patients were spared an unnecessary second-look laparotomy. Twenty-two patients with negative peritoneoscopies underwent laparotomy. Residual ovarian cancer was found in 12 (55%), mainly in the pelvis and mesentery. Thus, a negative peritoneoscopy must be followed by a laparotomy before a patient with ovarian cancer can be considered disease free. Peritoneoscopy was found to be a safe and feasible procedure, even in patients who had prior laparotomies. It could not be performed for technical reasons in only 6% of the patients. There were few serious complications and in only 2.5% of the cases was medical therapy required to deal with a complication. There were no deaths or perforations of the viscus and no patient required surgical exploration because of a peritoneoscopy complication.

Abdominal Neoplasms↗
PubMed1980

Peritoneoscopy in chronic hepatitis. A retrospective evaluation of its role in the management of the asymptomatic patient.

The course of chronic hepatitis was retrospectively evaluated in 26 patients in whom both peritoneoscopy and liver biopsy were initially performed. At entry all patients were clinically asymptomatic and showed mild or moderate histological and chemical abnormalities, so that none of them needed steroid treatment. The duration of the follow-up ranged from 24-82 months. At the end of follow-up liver biopsy was obtained in all patients. In a few patients peritoneoscopy was also ultimately performed. In six patients in whom initially chronic persistent hepatitis (CPH) was diagnosed both by peritoneoscopy and liver biopsy, the subsequent course of the disease was benign. In all the nine patients in whom initially peritoneoscopy suggested CPH, in contrast to the histological diagnosis of chronic aggressive hepatitis (CAH), chemical and morphological parameters of liver disease activity did not worsen to require steroid treatment. In five of six patients in whom both liver biopsy and peritoneoscopy initially showed CAH, chemical and morphological abnormalities progressed so that steroids had to be initiated. Finally in four of five patients in whom initially peritoneoscopy showed CAH and liver biopsy CPH, steroid treatment was ultimately required because of chemical and morphological worsening. In conclusion peritoneoscopy may be a useful aid in the management of the asymptomatic patient with moderate chemical and histological features of chronic liver disease.

Adolescent↗
PubMed1978

The use of peritoneoscopy in the detection of liver metastases.

Peritoneoscopy was carried out in 352 cancer patients with clinical suspicion of liver involvement in most cases. Principally because of patient discomfort, adequate liver biopsy was obtained in only 66% of 240 patients who underwent peritoneoscopy under local anesthesia while, under general anesthesia, biopsies could be taken in 90% of 112 patients. When the liver was macroscopically free of disease, the yield of positive peritoneoscopy was minimal regardless of the number of blind deep biopsies. Peritoneoscopy provided histologic demonstration of hepatic invasion in a total of 55 patients. Seven false-negative examinations out of 19 negative peritoneoscopies (36%) were identified by subsequent laparotomy or autopsy within 2 months. These preliminary data, although difficult to interpret in terms of accuracy of the method, point to the possible contributions of peritoneoscopy in detecting liver metastases.

Biopsy, Needle↗
PubMed1983

Computed tomography and peritoneoscopy for detection of liver metastases: review of Mayo Clinic experience.

The effectiveness of computed tomography (CT) and peritoneoscopy in detecting liver metastasis was studied by review of 97 cases in which both of these procedures and also biopsy or autopsy were performed. Tissue examinations disclosed hepatic lesions in 45 cases. The sensitivity of CT and peritoneoscopy was 89 and 62%, respectively; and their specificity 94 and 96%. In 35% of biopsy-proven cases, CT detected lesions not visible at peritoneoscopy; and in 7% peritoneoscopy revealed lesions not shown by CT. The difference resulted from the more frequent occurrence of liver metastases in locations more suitable for CT detection. The results suggest that CT should be tried before peritoneoscopy (other considerations being equal), and that CT guidance for biopsy deserves more frequent use. The reliability of negative CT or peritoneoscopy findings remains uncertain, since autopsy has been obtained in only 3 of the 52 negative cases.

Adolescent↗
PubMedDate not supplied

Peritoneoscopy: experience in Sudan.

INTRODUCTION: The use of peritoneoscopy is an established method for diagnosis of intra abdominal diseases. In industrialized countries such as USA and Germany its use has declined with the advent of modern imaging techniques. However it is believed that there is an important rationale for its use in developing countries. STUDY AIMS: A retrospective study to assess the value of peritoneoscopy in a developing country (Sudan). PATIENTS AND METHODS: A total of 274 patients were included in this study. Peritoneoscopy was performed in the endoscopy theatre, using standard techniques. Biopsy specimens were taken, when required, from relevant tissues. The patients were closely monitored during and following the procedure. RESULTS: Peritoneoscopy was indicated for assessment of hepatomegaly in 108 (39.1%) patients, exudative ascites 66 (24%), diagnosis of abdominal mass 48 (17.5%) and miscellaneous indications 52 (19.4%). The final diagnosis of all cases after peritoneoscopy included malignancies other than hepatocellular carcinoma (HCC) 81 (29.8%) patients, miscellaneous conditions 60 (21.8%), HCC 45 (16.4%), liver cirrhosis 26 (9.4%), abdominal tuberculosis 24 (9.4%), normal liver 16 (5.8%), hepatosplenic schistosomiasis (HSS) 15 (5.5%) and amoebic liver abscess 7 (2.5%). The peritoneoscopic appearance of HSS was very characteristic. CONCLUSION: This large study confirms that peritoneoscopy has a high diagnostic yield and is a cost-effective technique for use in developing countries.

Abdominal Neoplasms↗
PubMed1977

Peritoneoscopy as a diagnostic supplement to liver function tests and liver scan in patients with carcinoma.

Liver function tests, liver scintigraphy and peritoneoscopy were carried out in 240 patients with carcinoma. Hepatic invasion was demonstrated by peritoneoscopy essentially when both of the other tests were positive. However, in one-third of the patients, peritoneoscopy revealed the presence of other pathologic changes which could account for the positivity of either of the other diagnostic procedures. The status of the liver, with regard to presence or absence of metastases, could be microscopically documented in 59 patients. False-negative findings of liver chemistry tests, liver scan and peritoneoscopy were seen in 27, 42 and 36 per cent, respectively, of the patients while the rate of false-positive results was 15, 10 and 3 per cent, respectively. The rate of false-negative peritoneoscopy examinations in the absence of simultaneous positivey of the two other investigations was insignificant. These data indicate that liver chemistry tests, liver scan and peritoneoscopy play a major and complementary role in the screening of patients with carcinoma.

Biopsy↗
PubMed1988

Peritoneoscopy for the diagnosis of acute appendicitis in females of reproductive age.

The diagnosis of acute appendicitis in women of reproductive age can be a difficult clinical problem. A retrospective audit found our incidence of normal appendix removal in this patient population to be 42%. This study was undertaken to determine if the selective use of peritoneoscopy would improve the accuracy of diagnosis and thereby reduce the need for celiotomy in these patients. Peritoneoscopy was performed on 21 patients, and acute appendicitis was confirmed in 12 cases. Tubo-ovarian pathology was found in 5 patients, no pathology was found in 4 patients, and an unnecessary celiotomy was avoided in 8 patients. The incidence of normal appendix removal was reduced to 15%. There were no serious complications associated with peritoneoscopy. Diagnostic peritoneoscopy should be liberally employed in women of reproductive age with suspected appendicitis.

Adolescent↗
PubMed1984

Peritoneoscopy in the diagnosis of liver abscess. Experience with 108 cases during a 10-year period.

Among 4569 cases of peritoneoscopy performed in a period of 10 years (1972-1981), 108 patients with liver abscesses were encountered. The diagnosis of hepatic abscess was made on the basis of gross liver inspection and confirmed or disproved by needle puncture biopsy, histopathologic study, or surgery. Peritoneoscopy is a valuable procedure for the diagnosis of liver abscess. Liver aspiration under direct vision during peritoneoscopy yields more dependable material for the diagnosis of liver abscess than blind liver aspiration. Moreover, during peritoneoscopy one can choose more accurately the site for the insertion of the aspirating needle.

Adolescent↗
PubMed2000

Proposed abdominal sonographic staging to predict severity of liver diseases: analysis with peritoneoscopy and histology.

Abdominal sonography is a routinely used noninvasive modality for screening and treatment of liver diseases. We attempted to establish a morphological sonographic staging to predict the severity of liver diseases with their consequent analysis with morphological staging of peritoneoscopy and histology. In all, 136 patients were enrolled for the final confirmation of disease state by peritoneoscopy and histology preceded by abdominal sonography. All patients were categorized from stage 0 to stage 5, depending on a proposed criterion of sonographic features based on surface pattern of liver and the appearance of internal echogenic bands relating to the irregularity of the liver texture. A digitized computer quantitation of histogram-based standard deviation (SD) values from different stages of sonographic images was analyzed, and their values were justified by correlation with the definite appearance of an internal echogenic band. The association of different sonographic stages with disease progression was also demonstrated by their relation with peritoneoscopy and histology. In all patients, the different sonographic staging results were significantly correlated with hepatic surface features of peritoneoscopic staging (r = 0.939, P < 0.0001) graded from stage 0 to stage 5 and were also correlated with biopsy-proven staging of fibrosis (r = 0.739, P < 0.0001). The greater SD values of histogram-based echo levels, as analyzed from digitized sonographic images of 90 patients, were associated with the appearance of internal echogenic bands (P < 0.0001). Furthermore, the corresponding SDS were significantly correlated with the qualitative staging of sonographic features (r = 0.781, P < 0.0001), peritoneoscopy (r = 0.786, P < 0.0001) and histology (r = 0.779, P < 0.0001). We concluded that our proposed sonographic staging is well correlated with peritoneoscopic and histological staging of liver diseases, with only a small discrepancy, and can be used clinically to demonstrate the ongoing severity of liver diseases.

Abdomen↗
PubMed1975

Peritoneoscopy: a valuable staging tool in ovarian carcinoma.

Peritoneoscopy was done within 1 month of exploratory laparotomy in 30 consecutive patients, with ovarian carcinoma as part of their pretreatment evaluation. Six of the 7 patients who were thought to have ovarian carcinoma localized to the pelvis (stages I and II) were found to have advanced disease (stage III) at peritoneoscopy and thus required a change in therapy. Metastatic diaphragmatic involvement in ovarian carcinoma is common and was found in 77 percent of all patients studied. The routine shielding if the liver area ordinarily used with total abdominal radiotherapy would select these patients for therapeutic failure. Peritoneoscopy supplied reevaluable finding in 2 of 7 patients having normal physical, roentgenologic, and laboratory examinations, as well as in 93 percent of all patients stuided. "Second look" peritoneoscopy precluded the need the laparotomy in 5 to 13 patients achieving as apparent clinical remission.

Carcinoma↗
PubMed1976

Peritoneoscopy in Hodgkin disease. Confirmation of results by laparotomy.

Peritoneoscopy was used to evaluate the liver in 35 previously untreated patients with Hodgkin disease. Four were found to have hepatic involvement. Of the 31 patients with normal peritoneoscopies, only one had liver disease demonstrated subsequently at confirmatory exploratory laparotomy. The diagnostic accuracy of peritoneoscopy was 93% for patients at high risk for hepatic disease and 97% for all patients studied. Morbidity from the procedure was minimal. There was no mortality. Peritoneoscopy is a highly accurate staging procedure that should be considered as an antecedent or as an alternative to laparotomy in patients with Hodgkin disease. Its accuracy and minimal morbidity should be considered in the critical selection process of determining which individuals should undergo laparotomy.

Biopsy, Needle↗
PubMed1975

Use of peritoneoscopy for initial staging and posttherapy evaluation of patients with ovarian carcinoma.

Forty patients with ovarian adenocarcinoma had peritoneoscopy within 1 month of their exploratory laparotomy as part of their pretreatment evaluation. Of 12 patients (58%) believed to have disease localized to the pelvis (stage 1 or II) at laparotomy staging 7 were found to have more advanced disease (stage III) at peritoneoscopy and thus required a change in therapy. Involvement of the diaphragm with metastatic ovarian carcinoma was found in 63% of all patients. This finding again necessitated a change in therapy, since the right hemidiaphragm is shielded along with the liver when abdominal radiotherapy is used. Peritoneoscopy supplied the only followable findings with which to gauge response to therapy in 40% of the patients and also supplied followable findings in 78% of all patients studied. Second-look peritoneoscopy was performed in all patients achieving an apparent clinical remission with chemotherapy. Active disease was found in 43% of these patients, which thus precluded the need for laparotomy.

Adenocarcinoma↗
PubMed1977

Peritoneoscopy: a technique to evaluate therapeutic efficacy in non-Hodgkin's lymphoma patients.

Peritoneoscopy was performed in 22 patients with non-Hodgkin's lymphoma as a re-staging technique to rule out relapse or persistence of active disease after intensive chemotherapy and/or radiotherapy. Fifteen patients with previous hepatic involvement achieved a complete clinical remission; however, five patients (33%) had persistent disease proved by biopsy at peritoneoscopy. In seven patients suspected to have a clinical relapse, peritoneoscopy biopsies documented relapse in three patients (43%), including two patients with negative percutaneous liver biopsies. Because of its low morbidity rate (4%), peritoneoscopy can be utilized to re-stage hepatic involvement by non-Hodgkin's lymphoma patients more accurately than percutaneous liver biopsies and with less morbidity than laparotomy.

Humans↗
PubMed1991

Peritoneoscopy in diagnosis of ascites.

Diagnostic peritoneoscopies were performed in 226 patients with ascites. Satisfactory examination was possible in 220 patients. Clinical diagnosis was confirmed at peritoneoscopy in 82.7% of patients. Peritoneoscopic examination corrected the clinical diagnosis in 13.7%, was inconclusive in 2.6% and was incorrect in 0.8% of cases. It was 100% diagnostic in malignant peritonitis and 89.5% in patients with tuberculous peritonitis. Pseudomyxoma peritoneai and mesothelioma were suspected in one patient each at peritoneoscopy and was confirmed histologically. The utility of routine ascitic fluid examination was reviewed in all patients. The ascitic fluid was transudative in 81.9%, exudative in 8.6% and indeterminate in 9.5% of patients with cirrhosis of liver. Patients with tuberculous pertitonitis had exudative, transudative and indeterminate ascites in 71.8%, 3.2% and 25% respectively. The ascites in patients with malignant peritonitis was either exudative (80%) or indeterminate (20%). There was considerable overlap in the nature of ascites present in the three groups of patients. We therefore conclude that peritoneoscopy is the most valuable investigation in the diagnosis of ascites, particularly in exudative and indeterminate types.

Ascites↗
PubMed1986

Peritoneoscopy for surgeons.

Peritoneoscopy is an invasive procedure. With attention to detail and a degree of dexterity which is inherent to surgery the procedure has been found safe in over 2,500 cases. Peritoneoscopy must always be a sequel to careful clinical examination. The greatest advantage of peritoneoscopy over all other diagnostic modalities is that peritoneoscopic diagnosis is a final histological diagnosis and has no element of shadow, image or conjecture. Peritoneoscopy has its greatest value in the diagnosis of liver pathology, in ascites, jaundice, malignancy and tuberculosis especially if non-invasive scanning techniques are not available. When used with discretion, it has some value in the management of the acute abdomen. Surgeons will be gratified to find the extent to which the peritoneoscope can help arrive at an early histological diagnosis, plan surgery, reduce morbidity by avoiding unnecessary surgery and shorten hospitalisation.

Ascites↗
PubMed1986

Peritoneoscopy in extrahepatic abdominal diseases.

Results of peritoneoscopy performed under local anesthesia were reviewed in 43 consecutive patients with predominantly extrahepatic disease. Patients with previous laparotomy scars and poor general condition were not refused the benefits of this procedure. Diagnostic accuracy was 84%. Histologic diagnosis was achieved in 42% of patients and cholecystocholangiography under peritoneoscopic guidance in two jaundiced patients. Laparotomy was avoided in 65% of patients, and peritoneoscopy correctly assessed local extent of gastric neoplasia in 76% (16/21). Complications were insignificant. Peritoneoscopy under local anesthesia is a quick, accurate, economic, and safe method for evaluating extrahepatic abdominal disease.

Abdomen↗
PubMed1977

[Emergency peritoneoscopy in blunt abdominal trauma and acute abdomen (author's transl)].

Peritoneoscopy, angiography, and peritoneal lavage are highly reliable methods for the detection of intraabdominal bleedings in blunt abdominal traumas. Acute peritonitis in severely ill patients can easily be detected by peritoneoscopy, but not by other methods. The results of emergency peritoneoscopy in 166 patients with blunt abdominal trauma and 115 patients with suspected peritonitis are reported.

Abdomen, Acute↗
PubMed1981

Radiographic contribution to diagnosis and treatment of complications from peritoneoscopy.

Peritoneoscopy is a valuable nonsurgical procedure for evaluating patients with malignant disease. Directed biopsies of suspected tumor masses may be obtained, and peritoneoscopy can frequently obviate the need for laparotomy. Although the complication rate is low, the radiologist must be aware of potential problems. Radiologists may participate not only in the diagnosis and localization of these complications but also in their therapy by interventional techniques. The radiographic findings in four patients with complications of peritoneoscopy are presented.

Adult↗