'Rollover' abdominal paracentesis versus standard technique: protocol of a crossover randomized comparative trial

Area of Science:

• Oncology
• Gastroenterology
• Diagnostic Cytopathology

Background:

• Peritoneal carcinomatosis diagnosis relies on detecting malignant cells in ascites.
• Standard abdominal paracentesis sensitivity for diagnosing peritoneal carcinomatosis ranges from 40-70%.
• Tumor cells preferentially accumulate in specific peritoneal recesses, potentially affecting diagnostic yield.

Purpose of the Study:

• To compare the diagnostic yield of a novel rollover paracentesis technique against the standard method.
• To assess cytological positivity for tumor cells in patients suspected of peritoneal carcinomatosis.
• To evaluate the effectiveness of the rollover technique in improving cancer cell detection.

Main Methods:

• A randomized crossover study design was employed.
• Each patient served as their own control.
• A blinded cytopathologist assessed cytological yield from both standard and rollover paracentesis techniques.

Main Results:

• The study aimed to compare tumor cell positivity between the standard and rollover paracentesis groups.
• Primary objective was to determine if the rollover technique increases cancer cell detection rates.
• Cytological yield was assessed to evaluate the diagnostic performance of each method.

Conclusions:

• The rollover technique shows potential for improving the detection of peritoneal carcinomatosis.
• Further analysis is needed to confirm if this technique enhances cytological yield compared to standard paracentesis.
• This comparative study provides insights into optimizing ascites fluid analysis for cancer diagnosis.