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Effect of Peritoneal Lavage on Surgery-induced Positive Peritoneal Cytology in Gastric Cancer Patients

Early Phase 1
Completed
Conditions
Gastric Cancer
Gastric Adenocarcinoma
Registration Number
NCT02287168
Lead Sponsor
Bezmialem Vakif University
Brief Summary

Surgical manipulation and handling of a tumor may cause dissemination of cancer cells through peritoneal cavity after curative gastrectomy. Intra operative peritoneal lavage may have preventive effect on positive peritoneal cytology occurred during gastrectomy in patients with gastric cancer.

Detailed Description

Peritoneal dissemination of gastric adenocarcinoma cells is the most frequent cause of death in patients with gastric cancer. Spreading of these cells occur by three routes: direct seeding via infiltration through gastric wall, via blood vessels and via perigastric lymphatic channels disturbed during lymph node dissection. Conversion of negative preoperative peritoneal cytology to positive cytology after curative gastrectomy has been shown by previous studies.

Although extensive intra-operative peritoneal lavage (1 L of physiologic saline 10 times) has been shown to be an effective method to eliminate cancer cell dissemination during surgery, to cause significant improvement in survival after gastrectomy, widespread use of this approach has not existed most probably due to its time consuming technical difficulty. Therefore,intra-operative peritoneal lavage (1 L of physiologic saline 3 times) may be used more frequently during gastric surgery.If it is possible to show effectivity of intra-operative peritoneal lavage using a total of 3 L physiologic saline to eliminate cancer cell dissemination occurred before or after gastric surgery, use of this approach may gain acceptance to decrease risk of peritoneal metastasis.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
34
Inclusion Criteria
  • Endoscopically proven gastric adenocarcinoma
  • Standard gastrectomy and a D2 lymph node dissection;
  • Desire to attend the study protocol
Exclusion Criteria
  • Metastatic or overt peritoneal disseminated cancer
  • Undesired reaction to attend the study protocol

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
eliminationat the operation

rate of conversion of positive cytology results to negative cytology by peritoneal lavage during the surgery

Secondary Outcome Measures
NameTimeMethod
disseminationat the operation

rate of conversion of negative cytology results to positive cytology by surgery

Trial Locations

Locations (2)

Bezmialem Vakif University Faculty of Medicine Dept of General Surgery

🇹🇷

Istanbul, Turkey

Mustafa Hasbahceci

🇹🇷

Istanbul, Turkey

Bezmialem Vakif University Faculty of Medicine Dept of General Surgery
🇹🇷Istanbul, Turkey

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