Gastric Adenocarcinoma, Gastric Cancer
Conditions
Keywords
Peritoneal lavage, Dissemination, Gastrectomy, Cytology, Lavage
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.
Interventions
PROCEDUREpre-gastrectomy peritoneal washing cytology
sampling of peritoneal washing fluid before gastrectomy
PROCEDUREpost-gastrectomy peritoneal washing cytology
sampling of peritoneal washing fluid after gastrectomy
PROCEDUREpost-lavage peritoneal washing cytology
sampling of peritoneal washing fluid after peritoneal lavage
Sponsors
Bezmialem Vakif University
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| elimination | at the operation | rate of conversion of positive cytology results to negative cytology by peritoneal lavage during the surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| dissemination | at the operation | rate of conversion of negative cytology results to positive cytology by surgery |
Countries
Turkey (Türkiye)
Outcome results
None listed