title: Effects of carbon dioxide pneumoperitoneum, air pneumoperitoneum, and gasless laparoscopy on body weight and tumor growth.
abstract: BACKGROUND
  The oncologic consequences of intraperitoneal carbon dioxide (CO2) insufflation during the laparoscopic resection of cancer are under debate. The effect of other insufflating gases or gasless laparoscopy on cancer requires study.
  
  
  OBJECTIVE
  To study body weight and tumor growth in rats after CO2 pneumoperitoneum, air pneumoperitoneum, and gasless laparoscopy.
  
  
  METHODS
  On day 1, an 8-mg bolus of ROS-1 tumor was placed under the renal capsule of both kidneys in rats. In experiment A, rats had either CO2 insufflation (n=10) or a gasless laparoscopic bowel resection (n=10) on day 3 and were humanely killed after 7 days. In experiment B, rats had either a laparoscopic bowel resection with CO2 insufflation (n=11) or insufflation with air (n=11) on day 3 and were killed after 7 days. In both experiments, postoperative weight loss and tumor growth were measured, and the differences were tested with an analysis of covariance.
  
  
  RESULTS
  Renal subcapsular tumor growth in the group having gasless laparoscopy was less than that in the group having CO2 pneumoperitoneum (P=.04). Postoperative weight loss in these groups showed no differences (P=.55). No differences in tumor growth or weight loss were found between rats having insufflation with CO2 and those having insufflation with air (P=.61 and P=.68, respectively).
  
  
  CONCLUSIONS
  The restoration of body weight after a laparoscopic surgical procedure was similar with CO2, air, or gasless laparoscopy. Gasless laparoscopy was associated with less renal subcapsular tumor growth than was insufflation with CO2. Therefore, the application of gasless techniques in laparoscopic oncologic surgical treatment demands further study.
authors.affiliation: Department of Surgery, University Hospital Rotterdam, Dijkzigt, The Netherlands.
authors.forename: N D
authors.initials: ND
authors.lastname: Bouvy
authors.forename: M C
authors.initials: MC
authors.lastname: Giuffrida
authors.forename: L N
authors.initials: LN
authors.lastname: Tseng
authors.forename: E W
authors.initials: EW
authors.lastname: Steyerberg
authors.forename: R L
authors.initials: RL
authors.lastname: Marquet
authors.forename: H
authors.initials: H
authors.lastname: Jeekel
authors.forename: H J
authors.initials: HJ
authors.lastname: Bonjer
mesh_terms: D000388:Air; D000818:Animals; D001835:Body Weight; D001859:Bone Neoplasms / Q000473:pathology* / Q000601:surgery*; D002245:Carbon Dioxide; D007668:Kidney; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D009368:Neoplasm Transplantation; D012516:Osteosarcoma / Q000473:pathology* / Q000601:surgery*; D011027:Pneumoperitoneum / Q000209:etiology*; D051381:Rats; D011919:Rats, Inbred Strains; D013977:Tibia
chemical_list: D002245:Carbon Dioxide