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Effect of preservation of the right gastro-epiploic artery on delayed gastric emptying after cytoreductive surgery and HIPEC : a randomized clinical trial

Evers, D J ; Smeenk, R M ; Bottenberg, P D ; van Werkhoven, E D ; Boot, H and Verwaal, V J LU (2011) In European Journal of Surgical Oncology 37(2). p.162-167
Abstract

BACKGROUND: Delayed gastric emptying (DGE) is a main complication with unknown origin after a cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS-HIPEC). The aim of this study was to investigate if preservation of the right gastro-epiploic artery (GEA) during standard omentectomy would have a positive effect on gastric emptying after CRS-HIPEC.

METHODS: Forty-two patients subjected to a CRS-HIPEC were randomized into two groups perioperatively before performing an omentectomy: in Group I (N = 21) omentectomy was performed with preservation of the GEA; in Group II (N = 21) omentectomy was performed with resection of the GEA. The primary endpoint was the number of days to full oral intake of solid food.... (More)

BACKGROUND: Delayed gastric emptying (DGE) is a main complication with unknown origin after a cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS-HIPEC). The aim of this study was to investigate if preservation of the right gastro-epiploic artery (GEA) during standard omentectomy would have a positive effect on gastric emptying after CRS-HIPEC.

METHODS: Forty-two patients subjected to a CRS-HIPEC were randomized into two groups perioperatively before performing an omentectomy: in Group I (N = 21) omentectomy was performed with preservation of the GEA; in Group II (N = 21) omentectomy was performed with resection of the GEA. The primary endpoint was the number of days to full oral intake of solid food. Secondary endpoints were number of days to intended occlusion of gastrostomy catheter and total hospital admission time.

RESULTS: No significant differences were discovered between both groups in any of the study endpoints after CRS-HIPEC. No significant differences were observed in patient or operation characteristics between the randomized groups.

CONCLUSIONS: No association was demonstrated between preservation of the gastro-epiploic artery during omentectomy and gastric emptying after CRS-HIPEC. The extensive intestinal manipulation or the heated intra-peritoneal chemotherapy during surgery are more plausible causes of this phenomenon. This clinical trial was registered in the Netherlands at the Central Committee on Research involving Human Subjects (CCMO) under registration number P06.0301L.

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author
; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Adenocarcinoma/therapy, Adult, Aged, Female, Gastric Emptying, Humans, Hyperthermia, Induced, Male, Middle Aged, Omentum/surgery, Peritoneal Neoplasms/therapy, Stomach/blood supply, Treatment Outcome
in
European Journal of Surgical Oncology
volume
37
issue
2
pages
162 - 167
publisher
Elsevier
external identifiers
  • scopus:79251593663
  • pmid:21216560
ISSN
1532-2157
DOI
10.1016/j.ejso.2010.12.005
language
English
LU publication?
no
additional info
Copyright © 2010 Elsevier Ltd. All rights reserved.
id
50cb07fc-c43c-483d-80ec-a5bcd0498a77
date added to LUP
2022-04-05 11:17:48
date last changed
2024-01-09 12:39:41
@article{50cb07fc-c43c-483d-80ec-a5bcd0498a77,
  abstract     = {{<p>BACKGROUND: Delayed gastric emptying (DGE) is a main complication with unknown origin after a cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS-HIPEC). The aim of this study was to investigate if preservation of the right gastro-epiploic artery (GEA) during standard omentectomy would have a positive effect on gastric emptying after CRS-HIPEC.</p><p>METHODS: Forty-two patients subjected to a CRS-HIPEC were randomized into two groups perioperatively before performing an omentectomy: in Group I (N = 21) omentectomy was performed with preservation of the GEA; in Group II (N = 21) omentectomy was performed with resection of the GEA. The primary endpoint was the number of days to full oral intake of solid food. Secondary endpoints were number of days to intended occlusion of gastrostomy catheter and total hospital admission time.</p><p>RESULTS: No significant differences were discovered between both groups in any of the study endpoints after CRS-HIPEC. No significant differences were observed in patient or operation characteristics between the randomized groups.</p><p>CONCLUSIONS: No association was demonstrated between preservation of the gastro-epiploic artery during omentectomy and gastric emptying after CRS-HIPEC. The extensive intestinal manipulation or the heated intra-peritoneal chemotherapy during surgery are more plausible causes of this phenomenon. This clinical trial was registered in the Netherlands at the Central Committee on Research involving Human Subjects (CCMO) under registration number P06.0301L.</p>}},
  author       = {{Evers, D J and Smeenk, R M and Bottenberg, P D and van Werkhoven, E D and Boot, H and Verwaal, V J}},
  issn         = {{1532-2157}},
  keywords     = {{Adenocarcinoma/therapy; Adult; Aged; Female; Gastric Emptying; Humans; Hyperthermia, Induced; Male; Middle Aged; Omentum/surgery; Peritoneal Neoplasms/therapy; Stomach/blood supply; Treatment Outcome}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{162--167}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Surgical Oncology}},
  title        = {{Effect of preservation of the right gastro-epiploic artery on delayed gastric emptying after cytoreductive surgery and HIPEC : a randomized clinical trial}},
  url          = {{http://dx.doi.org/10.1016/j.ejso.2010.12.005}},
  doi          = {{10.1016/j.ejso.2010.12.005}},
  volume       = {{37}},
  year         = {{2011}},
}