Extensive peritoneal lavage with saline after curative gastrectomy for gastric cancer (EXPEL): a multicentre randomised controlled trial

Does Extended Intraoperative Peritoneal Lavage Really Bring Benefit on Patients With Gastric Cancer? A Meta-Analysis of Published Clinical Trials

“…The probable mechanism was that EIPL was performed 10 times with 1 L of saline, and the dilution method could greatly reduce the amount of damaged tissues and wound exudates in the peritoneum and clean the peritoneal cavity. However, another study found that the EIPL group had higher adverse events ( 19 ). It might be related to bowel manipulation during lavage and higher number of superficial wound infections in the EIPL group.…”

“…Previous studies reported that EIPL could prolong OS and reduce complications (16,17). However, other studies have shown that EIPL does not bring significant survival benefits and complications (18)(19)(20). Therefore, it is necessary to analyze the exact efficacy of EIPL.…”

“…Data regarding overall postoperative complications were extracted from four studies (16,(18)(19)(20). After pooling up the data, no significant difference was found between EIPL group and No EIPL group (OR = 0.88, 95% CI = 0.51 to 1.53, P = 0.65) (Figure 3A).…”

“…There were four studies reporting OS (17)(18)(19)(20) and two studies reporting DFS and PRFS (18,19). After pooling up all the data, no significant difference was found between EIPL group and No EIPL group in terms of OS (HR = 0.77, 95% CI = 0.36 to 1.64, P = 0.49) (Figure 4A), DFS (HR = 0.97, 95% CI = 0.71 to 1.33, P = 0.87) (Figure 5A), and PRFS (HR = 1.03, 95% CI = 0.74 to 1.43, P = 0.86) (Figure 5B).…”

“…Previous studies have reported that EIPL could prolong overall survival and reduce complications (16,17). However, other studies have shown that EIPL does not bring significant survival benefits and complications (18)(19)(20). Therefore, the purpose of the current meta-analysis is to analyze whether EIPL can bring benefit on short-term outcomes or survival.…”