title: Effect of preservation of the right gastro-epiploic artery on delayed gastric emptying after cytoreductive surgery and HIPEC: a randomized clinical trial.
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. 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.
authors.affiliation: Department of Surgery, The Netherlands Cancer Institute NKI-AVL, Amsterdam, The Netherlands. d.evers@nki.nl
authors.forename: D J
authors.initials: DJ
authors.lastname: Evers
authors.forename: R M
authors.initials: RM
authors.lastname: Smeenk
authors.forename: P D
authors.initials: PD
authors.lastname: Bottenberg
authors.forename: E D
authors.initials: ED
authors.lastname: van Werkhoven
authors.forename: H
authors.initials: H
authors.lastname: Boot
authors.forename: V J
authors.initials: VJ
authors.lastname: Verwaal
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000328:Adult; D000368:Aged; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000628:therapy*; D013270:Stomach / Q000098:blood supply*; D016896:Treatment Outcome