Port-site metastasis in the abdominal wall: fact or fiction?
Port-site metastasis (PSM) following minimally invasive surgery (MIS) is discussed and four points are addressed: 1) the occurrence of PSM; 2) the occurrence of PSM as part of distant metastasis, and the need for more studies to confirm that it can occur purely as implantation metastasis; 3) the preliminary experimental evidence suggesting that carbon dioxide might have a role in PSM and that viable cells can be dispersed by pneumoperitoneum (with more experimental work and clinical studies needed to confirm these observations); and 4) some studies showing an increased incidence of PSM after MIS compared with open surgery. Prospective randomized studies with adequate follow-up are needed to establish the validity of such reports.
Yale University School of Medicine, Department of Surgery, New Haven, Connecticut, USA. rsavalgi99@aol.com
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D000008:Abdominal Neoplasms / Q000453:epidemiology / Q000556:secondary*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009366:Neoplasm Seeding; D009369:Neoplasms / Q000601:surgery*