Laparoscopy, thoracoscopy and bronchoscopy can be used in addition to EUS and CT in locally advanced esophageal cancer to accurately diagnose and stage lymph node metastasis.
Laparoscopic and thoracoscopic staging can be used to more accurately stage regional lymph nodes (particularly celiac and intrathoracic) as compared to EUS.[1][2]
They can be used to determine intraperitoneal metstases in those patients with distal esophageal adenocarcinomas.[3]
Furthermore, laparoscopy and thoracoscopy is used to limit aggressive treatment in those who have a locally advanced cancer.
Preoperative bronchoscopy with biopsy and brush cytology has been implemented recently as the last phase in staging workup in those with a locally advanced tumor that is located at or above the carina.[4]
↑Kaushik N, Khalid A, Brody D, Luketich J, McGrath K (2007). "Endoscopic ultrasound compared with laparoscopy for staging esophageal cancer". Ann. Thorac. Surg. 83 (6): 2000–2. doi:10.1016/j.athoracsur.2007.02.023. PMID17532386.
↑Krasna MJ, Reed CE, Nedzwiecki D, Hollis DR, Luketich JD, DeCamp MM, Mayer RJ, Sugarbaker DJ (2001). "CALGB 9380: a prospective trial of the feasibility of thoracoscopy/laparoscopy in staging esophageal cancer". Ann. Thorac. Surg. 71 (4): 1073–9. PMID11308139.