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Comment & Response
August 14, 2019

Combination of Surgery With Extensive Intraoperative Peritoneal Lavage for Patients With Advanced Gastric Cancer

Author Affiliations
  • 1Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
  • 2IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo, Japan
JAMA Surg. Published online August 14, 2019. doi:10.1001/jamasurg.2019.2661

To the Editor Guo et al1 found that extensive intraoperative peritoneal lavage (EIPL) can be the prophylactic procedure of postoperative complications after D2 resection of locally advanced gastric cancer. Postoperative abdominal pain was observed more often in the surgery alone group (48 of 271 patients [17.7%]) compared with the surgery plus EIPL group (30 of 279 patients [10.8%]) (difference, 7.0%; 95% CI, 0.8%-13.1%; P = .02). It also showed significant difference in the postoperative complication rate between the surgery alone group (46 of 271 patients [17.0%]) and the surgery plus EIPL group (31 of 279 patients [11.1%]) (difference, 5.9%; 95% CI, 0.1%-11.6%; P = .04). Although surgery plus EIPL could be a new standard strategy of advanced gastric cancer owing to the reduction of postoperative complications safely and simply at a very low cost, we have some concerns about cytologic analysis.

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