Peritoneal lavage with distilled water during liver resection in patients with spontaneously ruptured hepatocellular carcinomas

Abstract

Spontaneously rupture of hepatocellular carcinoma is a life threatening and worse prognosis. Not only the lower rate of resection and hemodynamic unstable, but also the hepatic failure and recurrence. Distilled water irrigation had been applied in several cancer surgeries including colon, stomach, breast, ovary, and bladder; thus had good results in lowering the tumor spreading. We applied distilled water peritoneal lavage after liver resection in patients with spontaneous rupture of hepatocellular carcinoma to define the influence of prognosis. Thirteen patients with spontaneous ruptured hepatocellular carcinoma underwent distilled water peritoneal lavage after curative liver resection (Group A). Nineteen patients with spontaneous ruptured hepatocellular carcinoma did not undergo distilled water peritoneal lavage after curative liver resection (Group B). There were 11 patients of tumor recurrence in Group B; 2 in Group A. The mean disease-free time of Group B was 2.05 +/- 0.74 years; for Group A it was 3.59 +/- 0.60 (P = 0.045). Peritoneal lavage in this series resulted in significantly better survival time for the patients in Group A (P = 0.0158). That implies distilled water peritoneal lavage during liver resection would retard the tumor recurrence and further improve the survival rate in patients with spontaneously ruptured hepatocellular carcinoma.

Pleural lavage with distilled water during surgery for esophageal squamous cell carcinoma

“…Therefore, it is suggested that surgical manipulation only occasionally exfoliates and spreads cancer cells in the surgical field. Some previous studies have indicated cytocidal effects of hypotonic shock on cancer cells (15)(16)(17). A previous report demonstrated the cytocidal activity of distilled water on colorectal cancer cell lines in culture, and also discussed the optimal method of peritoneal lavage with distilled water during colorectal cancer surgery (15).…”

Efficacy of Postoperative Bladder Irrigation with Water for Injection in Reducing Recurrence Rates of Non Muscle Invasive Bladder Cancer

“…After the first report of Price in 1905, water for injection has been widely used for the irrigation of peritoneal cavity in order to destroy released cancer cells after surgery for several types of cancers including colorectal, gastric and hepatocellurar cancer as well as for bladder irrigation after transurethral resection of bladder tumours (Price 1905;Moskovitz et al, 1987;Chen et al, 2001;Brundell et al, 2002;Huguet et al, 2004;Lin et al, 2006;Chang et al, 2013). Water for injection has been shown to destroy bladder cancer cells in vitro through osmotic lysis (cytolysis) while some studies suggest that it may be more effective than BCG (Bolkier et al, 1991;Nargund et al, 2012).…”

Spontaneous rupture of primary hepatocellular carcinoma: Experience of emergency laparotomy over a 16-year period

“…For resectable ruptured HCC patients, emergency liver resection can achieve good early and long-term results [17] . It has been reported that long-term results of emergency hepatectomy are similar to those receiving elective surgery [15][16][17][18] .…”

“…Peritoneal cavity lavage can clear the cancer cells that have already dispersed into the peritoneal cavity at the time of rupture. Lin et al [16] reported that distilled water peritoneal lavage resulted in significantly better survival time in patients with spontaneous rupture of HCC. For unresectable tumors, some local ablation methods are also effective in killing cancer cells, such as microwave coagulation, argon beam coagulation or injection of absolute alcohol.…”