Extensive Peritoneal Lavage (EIPL) with Saline After Curative D2 Gastric Resection For Treatment of Locally Advanced Gastric Cancer Patients

Objective: This study evaluated extensive intraoperative peritoneal lavage (EIPL) on overall survival (OS), adverse events, and recurrence type in gastric cancer patients who underwent curative D2 lymph node dissection.
Methods: Medical records of 235 patients undergoing D2 curative gastrectomy for clinically locally advanced gastric cancer without peritoneal carcinomatosis between January 2011 and October 2021 were reviewed retrospectively. Patients were grouped according to surgery plus EIPL and non-EIPL. Clinicopathological features and recurrence type, prognostic factors on OS, and incidence of adverse events were evaluated.
Results: The mean age of patients included in this study was 63 years in the EIPL group and 61 in the non-EIPL group. The OS rate of patients with EIPL was 63%, and the non-EIPL group was 61.6%. All postoperative complications were less in the EIPL group (p=0.008). Peritoneal metastases were less in the EIPL group (p=0.003).
Conclusion: Free cancer cells in the abdominal cavity may be detected due of tumor manipulation and lymphovascular dissection during surgery. Using EIPL can reduce peritoneal recurrence. Postoperative complications due to exudate, debris, and possible intestinal content caused by perioperative dissection can be prevented with EIPL.