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Surgery May 1965
Topics: Abdominal Injuries; Catheterization; Diagnosis; Equipment and Supplies; Hemoperitoneum; Humans; Intestinal Perforation; Peritoneal Cavity; Peritoneal Lavage; Punctures; Specimen Handling
PubMed: 14295771
DOI: No ID Found -
European Journal of Surgical Oncology :... Sep 2016The most common cause of tumour progression in advanced gastric cancer is peritoneal carcinosis (PC). The necessity to increase the survival in advanced diseases... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The most common cause of tumour progression in advanced gastric cancer is peritoneal carcinosis (PC). The necessity to increase the survival in advanced diseases suggested to deliver the chemotherapy directly in the peritoneal cavity also in Cy+/PC- and to experiment the effect of massive peritoneal lavage to wash out the tumour cells. The aim of this study is to investigate the gain in term of survival and peritoneal recurrence rate of the intraperitoneal chemotherapy and/or peritoneal lavage in patients with Cy+/PC-.
MATERIAL AND METHODS
A systematic review with meta-analysis of trials about the effect of intraperitoneal chemotherapy (IPC) and/or peritoneal lavage (PL) on positive cytology in gastric cancer without carcinosis.
RESULTS
Three trials have been included (164 patients: 76 received surgery alone, 51 surgery + IPC and 37 surgery + IPC + PL). Two- and five-years survival is increased by IPC (RR = 1.62, RR = 3.10). 2 and 5 years survival is further increased by IPC + PL (RR = 2.33, RR = 6.19). Peritoneal recurrence is reduced by IPC (OR = 0.45) and by IPC + PL (OR = 0.13).
CONCLUSIONS
Two- and five-years overall survival in patients with free cancer cells without carcinosis is incremented by intraperitoneal chemotherapy. Peritoneal lavage further increases these survival rates and also it further decreases the peritoneal recurrence rate.
Topics: Antineoplastic Agents; Carcinoma; Humans; Infusions, Parenteral; Peritoneal Cavity; Peritoneal Lavage; Peritoneal Neoplasms; Prognosis; Stomach Neoplasms; Survival Rate; Therapeutic Irrigation
PubMed: 27134147
DOI: 10.1016/j.ejso.2016.03.035 -
Clinics (Sao Paulo, Brazil) 2019Despite advances in diffuse peritonitis treatment protocols, some cases develop unfavorably. With the advent of vacuum therapy, the use of laparostomy to treat...
OBJECTIVE
Despite advances in diffuse peritonitis treatment protocols, some cases develop unfavorably. With the advent of vacuum therapy, the use of laparostomy to treat peritonitis has gained traction. Another treatment modality is continuous peritoneal lavage. However, maintaining this technique is difficult and has been associated with controversial results. We propose a new model of continuous peritoneal lavage that takes advantage of the features and benefits of vacuum laparostomy.
METHOD
Pigs (Landrace and Large White) under general anesthesia were submitted to laparostomy through which a multiperforated tube was placed along each flank and exteriorized in the left and lower right quadrants. A vacuum dressing was applied, and intermittent negative pressure was maintained. Peritoneal dialysis solution (PDS) was then infused through the tubes for 36 hours. The stability of peritoneostomy with intermittent infusion of fluids, the system resistance to obstruction and leakage, water balance, hemodynamic and biochemical parameters were evaluated. Fluid disposition in the abdominal cavity was analyzed through CT.
RESULTS
Even when negative pressure was not applied, the dressing maintained the integrity of the system, and there were no leaks or blockage of the catheters during the procedure. The aspirated volume by vacuum laparostomy was similar to the infused volume (9073.5±1496.35 mL versus 10165±235.73 mL, p=0.25), and there were no major changes in hemodynamic or biochemical analysis. According to CT images, 60 ml/kg PDS was sufficient to occupy all intra-abdominal spaces.
CONCLUSION
Continuous peritoneal lavage with negative pressure proved to be technically possible and may be an option in the treatment of diffuse peritonitis.
Topics: Animals; Laparotomy; Models, Animal; Negative-Pressure Wound Therapy; Peritoneal Lavage; Peritoneum; Swine; Tomography, X-Ray Computed; Vacuum
PubMed: 31291390
DOI: 10.6061/clinics/2019/e937 -
Colorectal Disease : the Official... Sep 2010This systematic review aimed to evaluate the efficacy, morbidity and mortality of laparoscopic peritoneal lavage for patients with perforated diverticulitis. (Review)
Review
AIM
This systematic review aimed to evaluate the efficacy, morbidity and mortality of laparoscopic peritoneal lavage for patients with perforated diverticulitis.
METHOD
We searched PubMed, EMBASE, Web of Science, the Cochrane Library and CINAHL databases, Google Scholar and five major publisher websites without language restriction. All articles which reported the use of laparoscopic peritoneal lavage for patients with perforated diverticulitis were included.
RESULTS
Two prospective cohort studies, nine retrospective case series and two case reports reporting 231 patients were selected for data extraction. Most (77%) patients had purulent peritonitis (Hinchey III). Laparoscopic peritoneal lavage successfully controlled abdominal and systemic sepsis in 95.7% of patients. Mortality was 1.7%, morbidity 10.4% and only four (1.7%) of the 231 patients received a colostomy.
CONCLUSION
There have been no publications of high methodological quality on laparoscopic peritoneal lavage for patients with perforated colonic diverticulitis. The published papers do, however, show promising results, with high efficacy, low mortality, low morbidity and a minimal need for a colostomy.
Topics: Diverticulitis, Colonic; Humans; Laparoscopy; Peritoneal Lavage; Peritonitis
PubMed: 19788490
DOI: 10.1111/j.1463-1318.2009.02052.x -
Clinical Techniques in Small Animal... Feb 2003Abdominal paracentesis, the percutaneous removal of abdominal fluid for diagnostic and therapeutic purposes, provides a rapid, easy, and safe method of diagnosing... (Review)
Review
Abdominal paracentesis, the percutaneous removal of abdominal fluid for diagnostic and therapeutic purposes, provides a rapid, easy, and safe method of diagnosing diseases with abdominal effusion. Commonly diagnosed diseases include peritonitis, hemoperitoneum, uroabdomen, and neoplasia. Other indications for abdominal paracentesis include shock without a known apparent cause, undiagnosed disease within the abdominal cavity, suspicion of postoperative gastrointestinal wound dehiscence, blunt or penetrating abdominal injury, and refractory abdominal pain for which a cause cannot be determined. In such cases, simple abdominal paracentesis or four-quadrant paracentesis can be performed and requires minimal equipment. Diagnostic peritoneal lavage is indicated when peritonitis or other effusive disease is suspected, but other techniques have failed to provide a diagnostic sample. Both abdominal paracentesis and diagnostic peritoneal lavage are effective methods for the early detection of disease before overt clinical signs are present.
Topics: Abdomen, Acute; Animals; Dog Diseases; Dogs; Paracentesis; Peritoneal Lavage
PubMed: 12772867
DOI: 10.1016/1096-2867(03)90023-5 -
Cirugia Espanola 2017The Spanish Association of Coloproctology (AECP) and the Coloproctology Section of the Spanish Association of Surgeons (AEC), propose this consensus document about...
Complicated diverticular disease: Position statement on outpatient management, Hartmann's procedure, laparoscopic peritoneal lavage and laparoscopic approach. Consensus document of the Spanish Association of Coloproctology and the Coloproctology Section of the Spanish Association of Surgeons.
The Spanish Association of Coloproctology (AECP) and the Coloproctology Section of the Spanish Association of Surgeons (AEC), propose this consensus document about complicated diverticular disease that could be used for decision-making. Outpatient management, Hartmann's procedure, laparoscopic peritoneal lavage, and the role of a laparoscopic approach in colonic resection are exposed.
Topics: Ambulatory Care; Diverticulum, Colon; Humans; Laparoscopy; Peritoneal Lavage
PubMed: 28416357
DOI: 10.1016/j.ciresp.2017.03.008 -
The Journal of Trauma May 1998To prospectively compare the speed, sensitivity, complications, and technical failures of percutaneous diagnostic peritoneal lavage (DPL) using a Veress needle versus... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial Review
OBJECTIVE
To prospectively compare the speed, sensitivity, complications, and technical failures of percutaneous diagnostic peritoneal lavage (DPL) using a Veress needle versus open DPL.
METHODS
One hundred seventy-six blunt trauma patients requiring DPL were prospectively randomized to undergo either open DPL using a standard technique or percutaneous DPL using an 18-gauge Veress needle to penetrate the peritoneal cavity, with the lavage catheter then being inserted over a guide wire.
RESULTS
Mean time to successful placement of the lavage catheter for the percutaneous Veress needle technique was 2.73 minutes versus 7.28 minutes for the open DPL technique (p < 0.001). Sixteen percent of open lavage procedures took more than 11 minutes; the majority (60%) of Veress needle lavage procedures took less than 2 minutes. There were no false-negative findings in either group, and there was one false-positive result in each group. A wound infection after an open DPL was the only complication. Poor return of lavage fluid (<200 mL) accounted for most technical failures; this was more prevalent with the percutaneous method (11.2%) than with the open technique (3.8%) (p < 0.05).
CONCLUSION
The percutaneous DPL method using a Veress needle is significantly faster than the open DPL method. The Veress needle lavage was as safe and as sensitive as the open lavage; however, technical failure occurred more frequently with the Veress needle lavage than with the open DPL.
Topics: Abdominal Injuries; Adult; False Positive Reactions; Female; Humans; Male; Needles; Peritoneal Lavage; Prospective Studies; Sensitivity and Specificity; Surgical Wound Infection; Treatment Failure
PubMed: 9603093
DOI: 10.1097/00005373-199805000-00023 -
World Journal of Surgery Sep 2010The use of peritoneal lavage in patients with acute pancreatitis remains controversial. While recent guidelines do not make a positive recommendation for its use, there... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The use of peritoneal lavage in patients with acute pancreatitis remains controversial. While recent guidelines do not make a positive recommendation for its use, there continues to be reports of clinical benefits from peritoneal lavage in this setting. The aim of this study was to systematically review the available randomized controlled trials of peritoneal lavage in patients with severe acute pancreatitis.
METHODS
The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and four major Chinese biomedical databases were searched. A random effects model was used in meta-analysis. The summary estimates were reported as risk ratios (RR) with corresponding 95% confidence interval.
RESULTS
Ten randomized controlled trials, encompassing a total of 469 patients, were included. When compared with conservative treatment, the use of peritoneal lavage did not result in a statistically significant difference in the risk of mortality (RR = 0.82; 95% CI 0.32-1.79; p = 0.69) and complications (RR = 1.33; 95% CI 0.99-2.12; p = 0.06). The use of peritoneal lavage with antiproteases, in comparison with peritoneal lavage only, also did not result in a statistically significant difference in the risk of mortality and complications.
CONCLUSION
The lavage of the peritoneal cavity in patients with severe acute pancreatitis does not appear to confer a clinical benefit. Whether lavage of the pancreatic bed after necrosectomy is beneficial has yet to be determined.
Topics: Acute Disease; Humans; Length of Stay; Pancreatitis; Peritoneal Lavage; Randomized Controlled Trials as Topic; Treatment Failure
PubMed: 20532765
DOI: 10.1007/s00268-010-0665-3 -
Postgraduate Medicine Mar 1989Peritoneal lavage is a useful adjunct to physical examination and to other traditional means of assessing the patient with potential intraabdominal injury. The procedure... (Review)
Review
Peritoneal lavage is a useful adjunct to physical examination and to other traditional means of assessing the patient with potential intraabdominal injury. The procedure is safe in experienced hands and may be easily and rapidly performed with a minimum of equipment. The information that lavage provides may spare some patients an exploratory laparotomy and, more important, may identify those patients who appear to be in stable condition but who, in fact, need immediate lifesaving intervention.
Topics: Abdominal Injuries; Erythrocyte Count; Hemorrhage; Humans; Laparotomy; Leukocyte Count; Peritoneal Lavage
PubMed: 2648366
DOI: 10.1080/00325481.1989.11700612 -
Lancet (London, England) Oct 1959
Topics: Humans; Peritoneal Lavage; Peritoneum
PubMed: 13857489
DOI: No ID Found