ISSN:
1530-0358
Schlagwort(e):
Tumor
;
Implants
;
Trocar
;
Port
;
Recurrence
;
Colon cancer
;
Colectomy
;
Laparoscopy
;
Pneumoperitoneum
Quelle:
Springer Online Journal Archives 1860-2000
Thema:
Medizin
Notizen:
Abstract INTRODUCTION: The aim of this study was to determine the effect of pneumoperitoneum on the rate of trocar-site implantation with decreasing inoculum of cancer cells. METHODS: A total of 0.5 ml of GW-39 human colon cancer cell suspensions at 1 percent (∼3.2×105 cells) and at 0.5 percent (∼1.6×105 cells; v/v) were injected into the abdomen of hamsters through a midline incision. Animals in each group were randomized to receive either pneumoperitoneum (1 percent=33; 0.5 percent=43) or not (1 percent=32; 0.5 percent=39). Gross and microscopic tumor implants were documented seven weeks later at four trocar sites. RESULTS: In the 1 percent group, pneumoperitoneum significantly increased trocar-site tumor implants from 50 to 71 percent (P〈0.001). Pneumoperitoneum also resulted in the following: 1) more frequent involvement of all four concurrent sites (38vs. 10 percent;P〈0.02); 2) more frequent palpable tumors (13vs. 5 percent;P〈0.01); 3) larger tumor mass (2.1±0.6 gvs. 0.2±0.1 g;P〈0.02). In the 0.5 percent group, pneumoperitoneum did not significantly increase trocar-site tumor implants, and it did not result in a larger tumor mass. The percent increase in trocar-site implants owing to pneumoperitoneum was influenced by the amount of tumor inoculum (21 percent in the 1 percent group; 10 percent in the 0.5 percent group). The mass of palpable tumor implants after pneumoperitoneum decreased with decreased inoculum: 1 percent =2.1±0.6 g; 0.5 percent=0.3±0.1 g (P〈0.0001). CONCLUSIONS: Pneumoperitoneum significantly increased both tumor implantation rate and mass when ∼3.2×105 colon cancer cells were injected into the peritoneal cavity. These effects of pneumoperitoneum diminished with one-half as many tumor cells injected in the peritoneal cavity.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1007/BF02238239
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