THE EFFECT OF SURGICAL MANIPULATION ON THE PERITONEAL DISSEMINATION OF THE STOMACH CANCER

Abstract

In gastric cancer the overall incidence of peritoneal metastases up to two years after gastric resection is 35-40%, even metastases were not detected macroscopically during operation. To study the influence of surgical manipulation on the peritoneal seeding we investigated prospectively 36 patients operated for gastric cancer between September 1995 - January 1998 in SSK Göztepe Educational Hospital. Free cancer cells In the peritoneal cavity were obtained by Douglas pouch swabbing by Culti-Plast Swab. Intraoperatively negative and postoperatively positive swabs were accepted peritoneally disseminated positive seedings. The results were evaluated by Bormann classification, histological type of tumor, width of serosal invasion, lymph nodes metastases and TNM staging. Intraoperative swabs were negative in 34 patients, suspicious in 1 patient and positive in 1patient. Postoperative swabs were negative in 27 patients, suspicious in 4 patients and positive in 5patients. It appears that in cancers invading gastric serosas the surgical manipulation may lead to peritoneal dissemination and seeding