Evidence map›Paper›PMID 42192964›Full record

ReviewCancers2026

Intraoperative Peritoneal Lavage for Detection of Malignant Cells: Technique, Evidence, Clinical Relevance and Future Perspectives.

Resa Puffert, Anna Quarder, Fabian Kockelmann, Thomas Wirth, Tanja Reineke-Plaaß, Mieke Raap, Moritz Schmelzle, Linda Feldbrügge, Beate Rau, Franziska Köhler

Abstract readReview
In one paragraph

Review in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Resa PuffertDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Anna QuarderDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Fabian KockelmannDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.ORCID 0009-0004-7726-1089
Thomas WirthDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Tanja Reineke-PlaaßDepartment of Pathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Mieke RaapDepartment of Pathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.ORCID 0000-0001-8338-6209
Moritz SchmelzleDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Linda FeldbrüggeDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Beate RauDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Franziska KöhlerDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesPeritoneal metastases represent a common manifestation of advanced gastrointestinal malignancies and are associated with poor survival. Their early detection is essential for adequate tumor staging, prognosis, and treatment selection, especially to avoid unnecessary surgery. Intraoperative peritoneal lavage has been established as a diagnostic tool to detect occult peritoneal disease. However, reported techniques, analytical methods, and detection rates vary considerably. The objective of this review was to summarize current approaches to intraoperative peritoneal lavage, evaluate different detection methods, and assess their clinical relevance.

methodsA literature search was performed using the PubMed database for studies published between 2015 and 2025. The search terms "intraoperative peritoneal lavage" or "peritoneal fluid cytology" were used. Studies were included if they evaluated peritoneal lavage as a diagnostic method for detecting malignant cells, including all primary tumors and disease stages. Articles focusing on lavage as a therapeutic intervention or lacking methodological details were excluded.

resultsPhysiological saline solution was used for lavage in all included studies, with volumes ranging from 10 to 1000 mL. Sampling was predominantly performed immediately after abdominal access in various abdominal sites. Detection methods varied widely, with conventional cytology being most frequently used, while molecular techniques were used in a smaller number of studies. Positive detection rates showed broad variations and were higher in advanced tumor stages. Conventional cytology showed limited detection rates compared to molecular approaches.

conclusionsIntraoperative peritoneal lavage remains a valuable but methodologically heterogeneous diagnostic tool with limited detection rates when relying on conventional cytology alone. Molecular techniques seem to improve the detection rate of occult peritoneal disease but require further standardization and validation before routine clinical implementation. The technique of peritoneal lavage should be standardized by implementing an international consensus including lavage sites, volume of applied fluid, and detection method.

Indexed as

intraoperative cancer stagingperitoneal cancerperitoneal lavageperitoneal metastasesperitoneal wash fluid

Identifiers

PMID42192964
PMCPMC13204108

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.