title: Implantation of colon cancer at trocar sites is increased by low pressure pneumoperitoneum.
abstract: BACKGROUND
  The purpose of this study was to determine the effect of pneumoperitoneum on the implantation of tumor at trocar sites.
  
  
  METHODS
  GW-39 human colon cancer cell suspension (0.5 ml of 2.5% v/v) was injected into the peritoneal cavity of golden Syrian hamsters through a 1 cm midline incision. Four 5 mm trocars were inserted through the anterior abdominal wall, and the midline incision was then closed. The animals were randomized to receive pneumoperitoneum (n = 62) or no pneumoperitoneum (n = 60) for 10 minutes. Tumor implantations at trocar sites and midline wound incisions were documented grossly and histologically 8 weeks later.
  
  
  RESULTS
  Tumor was identified in 86% (49 of 57) of control animals and 95% (52 of 55) of the experimental group (p = 0.20). Implants increased with pneumoperitoneum at the midline incision from 44% to 71% (p < 0.01) and at trocar sites from 41% to 64% (p < 0.00001).
  
  
  CONCLUSIONS
  Pneumoperitoneum significantly increased tumor implantation at trocar sites and midline incisions.
authors.affiliation: Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Wu
authors.forename: E B
authors.initials: EB
authors.lastname: Brasfield
authors.forename: L W
authors.initials: LW
authors.lastname: Guo
authors.forename: M
authors.initials: M
authors.lastname: Ruiz
authors.forename: J M
authors.initials: JM
authors.lastname: Connett
authors.forename: G W
authors.initials: GW
authors.lastname: Philpott
authors.forename: D B
authors.initials: DB
authors.lastname: Jones
authors.forename: J W
authors.initials: JW
authors.lastname: Fleshman
mesh_terms: D000818:Animals; D001835:Body Weight; D017690:Cell Transplantation; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery; D006224:Cricetinae; D006801:Humans; D010535:Laparoscopy; D008647:Mesocricetus; D009368:Neoplasm Transplantation / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D011312:Pressure; D013525:Surgical Instruments; D014407:Tumor Cells, Cultured