title: Influence of cytotoxic agents on intraperitoneal tumor implantation after laparoscopy.
abstract: OBJECTIVE
  Recent experimental studies suggest that laparoscopic surgery for abdominal malignancy may be associated with increased tumor implantation. This study investigated the influence of cytotoxic agents (administered intraperitoneally or intramuscularly) on implantation of a tumor cell suspension after laparoscopic surgery in an experimental model.
  
  
  METHODS
  Thirty-three Dark Agouti rats underwent laparoscopy with CO2 insufflation and instillation of a tumor cell suspension into the abdominal cavity. Rats were randomly allocated to one of the following study groups (9 rats in the control group, 6 rats in all other groups): 1) control (no intraperitoneal instillation); 2) intraperitoneal normal saline (0.9 percent); 3) intraperitoneal povidone-iodine (Betadine to normal saline 1:10 dilution); 4) intraperitoneal methotrexate (2 doses of 0.125 mg/kg body weight in normal saline administered 24 hours apart); 5) intramuscular injection of 2 doses of 0.125 mg/kg body weight administered 24 hours apart (no intraperitoneal agent). Rats were killed 7 days after the procedure, and the peritoneal cavity and port sites were examined for the presence of tumor.
  
  
  RESULTS
  A significant reduction in tumor implantation and port-site metastases was observed in all treatment groups (povidone-iodine and intramuscular and intraperitoneal methotrexate).
  
  
  CONCLUSIONS
  This study suggests that tumor implantation after laparoscopic surgery and port-site metastases might be prevented by the intraperitoneal or systemic administration of cytotoxic agents. Further studies are needed to determine whether these findings can be applied to clinical practice.
authors.affiliation: The Royal Adelaide Centre for Endoscopic Surgery, South Australia.
authors.forename: S J
authors.initials: SJ
authors.lastname: Neuhaus
authors.forename: D I
authors.initials: DI
authors.lastname: Watson
authors.forename: T
authors.initials: T
authors.lastname: Ellis
authors.forename: A M
authors.initials: AM
authors.lastname: Rofe
authors.forename: G G
authors.initials: GG
authors.lastname: Jamieson
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D007273:Injections, Intramuscular; D007274:Injections, Intraperitoneal; D010535:Laparoscopy / Q000009:adverse effects*; D008727:Methotrexate / Q000008:administration & dosage; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009366:Neoplasm Seeding; D009368:Neoplasm Transplantation; D010529:Peritoneal Cavity; D011206:Povidone-Iodine / Q000008:administration & dosage; D011897:Random Allocation; D051381:Rats
chemical_list: D000970:Antineoplastic Agents; D011206:Povidone-Iodine; D008727:Methotrexate