Randomized crossover trial of ‘Roll-over’ technique of abdominal paracentesis versus standard technique in suspected malignant ascites

Link to article at PubMed

Expert Rev Gastroenterol Hepatol. 2023 Feb 16. doi: 10.1080/17474124.2023.2181785. Online ahead of print.


BACKGROUND: The sensitivity of single abdominal paracentesis for peritoneal carcinomatosis (PC) varies from 40-70%. We hypothesized that rolling-over the patient before paracentesis might improve the cytological yield.

RESEARCH DESIGN AND METHODS: This was a monocentric pilot study with a randomized cross-over design. We compared the cytological yield of fluid obtained by roll-over technique (ROG) with standard paracentesis (SPG) in suspected PC. In the ROG group, patients were rolled side-to-side thrice, and the paracentesis was done within 1 minute. Each patient served as their own control, and the outcome assessor (cytopathologist) was blinded. The primary objective was to compare the tumor cell positivity between SPG and ROG groups.

RESULTS: Of 71 patients, 62 were analysed. Of 53 patients with malignancy-related ascites, 39 had PC. Most of the tumour cells were adenocarcinoma (30, 94%) with one patient each having suspicious cytology and one having lymphoma. The sensitivity for diagnosis of PC was (31/39) 79.49% in SPG group and (32/39) 82.05% in ROG group (p =1.00). The cellularity was similar between both the groups (good cellularity in 58% of SPG and 60% of ROG, p =1.00).

CONCLUSIONS: Rollover paracentesis did not improve the cytological yield of abdominal paracentesis.

PMID:36795510 | DOI:10.1080/17474124.2023.2181785

Leave a Reply

Your email address will not be published. Required fields are marked *