The Value Of Laparoscopy In The Diagnosis Of Women With Unexplained Ascites And Elevated Serum Tumor Marker Level

Background and ObjectiveAscites is one of the most common clinical symptoms. ascites is a consequence or combination of many different underlying diseases. The standard procedure to access ascites includes laboratory examinations and image investigations. The cause of ascites can be identified in the majority of patients by clinical and conventional laboratory examinations, but occasionally it cannot be determined without further investigation. Thus, we define ascites of unknown origin as the etiology of ascites that cannot be determined after conventional laboratory examinations and further imaging investigations. This poses a major diagnostic challenge for clinicians. Diagnostic laparoscopy as a minimally invasive technique has developed rapidly in recent years. This test is to assess the value of laparoscopic exploration in diagnosing women with unknown origin ascites and high serum tumor marker level.Materials and Methods1 Experimental samples:A total of 30 female patients with unknown origin ascites from Jan.2007 to Oct.2010, who underwent diagnostic laparoscopic to determine the causes of ascites at the first affiliated hospital of Zhengzhou University.2 Test methods:This is a retrospective study from chart review. We collected data on cases.3 Statistical analysis:The SPSS statistical package program 17.0 was used. Comparison between the two groups with t-test,α=0.05 were deemed significant.Results1 Among 30 cases,29 cases were identified by laparoscopic abdominal exploration and biopsy. The total definite diagnostic rate was 96.7%. One case was negative.2 The benign ascites and malignant ascites have the different features under laparoscope.3 There was no significant difference in CA125 level between benign ascites and malignant ascites group (t=1.015, P=0.33)4 Treatment and follow-up:All pelvic tuberculosis with ascites underwent antituberculosis therapy. Three cases gave up treatment. Twelve malignant tumors were treated by intraperitoneal chemotherapy.Clinical complete regression of ascites was achieved, and the tumor marker level decreased to normal level in 9 patients.There were significant differences of serum CA125 concentrations between the patients with carcinoma after 6 months treatment and their first serum CA125 test on admission (t=3.00,P=0.O1)5 There was no significant difference of summation fee between routine examinations and laparoscopic exploration (t=3.20, P=0.08)6 The summation time of routine examinations was obviously longer than laparoscopic exploration (t=5.37, P=0.00)ConclusionLaparoscopic technique with high definite diagnostic rate, less wound, recovered quick and time-saving is gradually becoming useful method for diagnosing women patients with complicated ascites and high serum tumor marker level.