To the Editor Guo et al¹ found that extensive intraoperative peritoneal lavage (EIPL) can be the prophylactic procedure of postoperative complications after D2 resection of locally advanced gastric cancer. Postoperative abdominal pain was observed more often in the surgery alone group (48 of 271 patients [17.7%]) compared with the surgery plus EIPL group (30 of 279 patients [10.8%]) (difference, 7.0%; 95% CI, 0.8%-13.1%; P = .02). It also showed significant difference in the postoperative complication rate between the surgery alone group (46 of 271 patients [17.0%]) and the surgery plus EIPL group (31 of 279 patients [11.1%]) (difference, 5.9%; 95% CI, 0.1%-11.6%; P = .04). Although surgery plus EIPL could be a new standard strategy of advanced gastric cancer owing to the reduction of postoperative complications safely and simply at a very low cost, we have some concerns about cytologic analysis.

Guo等[ ^1]的编辑发现，广泛的术中腹腔灌洗（EIPL）可以作为局部晚期胃癌D2切除术后预防术后并发症的方法。与手术加EIPL组（279例中的30例[10.8％]）相比，单独手术组（271例中的48例[17.7％]）观察到的腹痛更为频繁（差异，7.0％； 95％CI，0.8）。 ％-13.1％；P  = .02）。单手术组（271例中的46例[17.0％]）与手术加EIPL组（279例中的31例[11.1％]）之间的术后并发症发生率也有显着差异（差异5.9％； 95％CI ，0.1％-11.6％; P = .04）。尽管由于安全且简单地降低了术后并发症的发生率，手术加EIPL可能成为晚期胃癌的新标准治疗策略，但我们对细胞学分析仍存在一些担忧。