Intraperitoneal cell movement during abdominal carbon dioxide insufflation and laparoscopy

Hewett, Peter; Thomas, W. M.; King, G.; Eaton, Michael

doi:10.1007/bf02053808

Cited by 163 publications

(78 citation statements)

References 13 publications

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“…Prior reports suggested that high and/or pulsatile pneumoperitoneum, especially in lengthy procedures, may enhance migration tumor cells from the venous plexus of the bladder (whose pedicles are squeezed throughout the procedure) and contribute to early tumor recurrence 8,28,29 31 . However, the lymph node yield in the same study was the same for either approach and the differences reported were not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

et al. 2017

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“…In addition to the potential effects of pneumoperitoneum on the transfer of tumor cells, it has also been proposed that malignant cells may be transferred from the tumor to the port site by the aggressive manipulation of the tumor with laparoscopic instruments and the subsequent withdrawal and reinsertion of these contaminated instruments. Hewett et al 27 were the first to demonstrate this concept in a pig model. The importance of minimizing tumor manipulation is first detailed by Greco et al 16 Irrigating port sites with povidone iodine may lower the risk of port-site recurrence.…”

Section: Discussionmentioning

confidence: 99%

Port-site Metastasis after Minimally Invasive Surgery for Urological Malignancy: A Review of Literature

Pradeep¹,

Kumar²

2017

WJOLS

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“…Some authors also believe that recurrences would be a result of the advanced disease, and peritoneal carcinomatosis, in response to this hypothesis, would be related to the laparoscopic technique. However, some articles describe such implantations in resections of non-advanced type T1 tumor and even tumors not diagnosed in initial laparoscopic procedures 4,10,23,[31][32][33]37,50,[63][64][65]69,76,79,100 . Other authors believe that tumor implantation are associated with the process of tumor extraction using trocars 19,23,31,37,63,67,77,100 .…”

Section: Vol 32 Nºmentioning

confidence: 99%

Influence of pneumoperitoneum on tumor implantation in parietal incision: a comparative study of trocar incision and laparotomy in rats

Kagohara¹,

Costa²

2012

J. Coloproctol. (Rio J.)

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Kagohara OH, Costa SL. Influence of pneumoperitoneum on tumor implantation in parietal incision: a comparative study of trocar incision and laparotomy in rats. J Coloproctol, 2012;32(3): 214-222. ABSTRACT:Videolaparoscopic surgery has enabled great progress in surgical procedures. However, the literature shows great controversy concerning its indication in oncological surgery for possibly increasing the implantation of metastases. This experimental study was carried out to help solve this controversy and analyze the influence of pneumoperitoneum as a cause of this implantation. A comparative study between incisions of trocars of videolaparoscopy and conventional laparotomy was conducted. For this analysis, 30 Wistar rats were divided into two equal groups: laparotomic group (A), that underwent a 5 cm laparotomy, which was left exposed for 15 minutes; and another (B), in which a 3 mmHg pneumoperitoneum was created with CO 2 and two more trocars were inserted, maintaining the insufflation for the same period. In both groups, the tumor, Walker 256 carcinosarcoma, was inoculated in the surgical procedure. The evaluation was performed within the fifth and the seventh postoperative days. The result of the macroscopic evaluation indicated that the tumor invasion in group A reached 93.33% and the implantation in the laparoscopy incision reached 73.33%. Nevertheless, the histopathological exam showed tumor implantation in all incisions of both groups (100%). The study concluded that parietal tumor implantation is not influenced by pneumoperitoneum in incisions of trocars when compared with conventional laparotomy in rats.Keywords: laparoscopy; laparotomy; neoplasm metastasis; implantation; carcinosarcoma. RESUMO:A cirurgia videolaparoscópica proporcionou grande avanço nas técnicas cirúrgicas. No entanto, há controvérsia na literatura sobre sua indicação na cirurgia oncológica por possivelmente aumentar a implantação tumoral de metástases. No intuito de contribuir para esclarecer essa controvérsia, realizou-se este estudo experimental visando analisar a influência do pneumoperitônio como causa dessa implantação. Realizou-se um estudo comparativo entre incisões dos trocartes da videolaparoscopia e da laparotomia convencional. Para isso, foram utilizados 30 ratos Wistar divididos em dois grupos iguais: um laparotômico (A), que foi submetido à laparotomia com 5 cm de extensão, a qual ficou exposta por 15 minutos; e outro (B), no qual se efetuou pneumoperitônio de 3 mmHg com CO 2 e colocaram-se mais dois trocartes, mantendo-se insuflado pelo mesmo período. Em ambos os grupos, inoculou-se o tumor no ato operatório, o carcinossarcoma 256 de Walker. A avaliação deu-se entre o quinto e sétimo dia de pós-operatório. Como resultado na avaliação macroscópica, há invasão tumoral no grupo A de 93,33% e implantação na incisão laparoscópica de 73,33%. No exame histopatológico, porém, revelou-se implantação tumoral em todas as incisões de ambos os grupos (100%). Conclui-se que a implantação tumoral não sofre influência do pneumoperitônio...

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Intraperitoneal cell movement during abdominal carbon dioxide insufflation and laparoscopy

Abstract: These results suggest that movement of cells throughout the peritoneal cavity during laparoscopy is via contaminated instruments, but local cell movement by dispersion possibly within water vapor from the port may also occur.

Cited by 163 publications

References 13 publications

Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

Port-site Metastasis after Minimally Invasive Surgery for Urological Malignancy: A Review of Literature

Influence of pneumoperitoneum on tumor implantation in parietal incision: a comparative study of trocar incision and laparotomy in rats

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