Tumor growth and dissemination after laparotomy and CO2 pneumoperitoneum: a rat ovarian cancer model.
OBJECTIVE
To compare tumor growth, intraperitoneal implantation, and abdominal wall metastasis after laparotomy and CO2 pneumoperitoneum in a rat ovarian cancer model.


METHODS
To mimic intraoperative rupture of an ovarian tumor in a syngenic rat ovarian carcinoma model, 10(5) malignant cells were injected intraperitoneally after a 5-cm vertical midline laparotomy or after the insufflation of a CO2 pneumoperitoneum achieved with 4 mmHg or 10 mmHg intra-abdominal pressure. Two weeks later, the intraperitoneal tumor growth and the tumor dissemination were evaluated semiquantitatively with a scoring system. The scores attributed to each organ were added to calculate the dissemination score of each animal.


RESULTS
The mean (+/-SD) dissemination score was 83.4+/-12 in the laparotomy group and 67.3+/-16 and 71.9+/-17 in the 4 and 10 mmHg CO2 pneumoperitoneum groups, respectively (P < .01). The scores for the peritoneum were 21.8+/-3.8 in the 10 mmHg pneumoperitoneum group and 18+/-2.4 in the laparotomy group (P < .01). In the laparotomy group, the implant found along the midline scar accounted for a mean of 62.6+/-15% of the peritoneal score, whereas the trocar site metastases did not influence the peritoneal score in the pneumoperitoneum groups. The incidence of wound metastasis was 96% in the laparotomy group and 55% and 54% in the 4 mmHg and 10 mmHg pneumoperitoneum groups, respectively.


CONCLUSIONS
In this model, tumor growth was greater after laparotomy than after laparoscopy, but peritoneal tumor dissemination was more severe after CO2 pneumoperitoneum.
Canis
M
M
Department of Obstetrics, Gynecology and Reproductive Medicine, Polyclinique de l'Hotel Dieu, Clermont-Ferrand, France.
Botchorishvili
R
R
Wattiez
A
A
Mage
G
G
Pouly
J L
JL
Bruhat
M A
MA
D000818:Animals; D002245:Carbon Dioxide; D002455:Cell Division; D004195:Disease Models, Animal; D005260:Female; D007813:Laparotomy / Q000009:adverse effects*; D009366:Neoplasm Seeding; D010051:Ovarian Neoplasms / Q000473:pathology*; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D051381:Rats
D002245:Carbon Dioxide