- Extensive intraoperative peritoneal lavage (EIPL) during D2 gastrectomy for locally advanced gastric cancer leads to better short-term outcomes than surgery alone.
Why this matters
- The study is the first to show that EIPL can reduce complications, wound pain, and mortality associated with D2 gastrectomy.
- 550 patients from 11 centers in China were randomly assigned to surgery alone or surgery plus EIPL.
- Funding: Sun Yat-sen University Cancer Center.
- 5 postoperative deaths occurred in the surgery-alone group, 0 in surgery + EIPL (difference, 1.9%; P=.02).
- Postoperative abdominal pain was more common with surgery alone (17.7% vs 10.8%; P=.02).
- Among 550 patients who underwent gastrectomy, surgery alone vs surgery + EIPL:
- ≥1 postoperative complication, 17.0% vs 11.1%; P=.04.
- Ileus, 6.3% vs 5.0%.
- Intra-abdominal abscess, 1.9% vs 0.7%.
- Intra-abdominal bleeding, 2.6% vs 1.1%.
- Wound problems, 2.6% vs 1.8%.
- Deep-vein thrombosis, 0.7% vs 0%.
- Postoperative cardiac disease, 0.7% vs 0%.
- Postoperative pulmonary disease, 3.3% vs 2.5%.
- Some patients were excluded due to T1, T2, or M1 disease.