Influence of trocar placement and CO(2) pneumoperitoneum on port site metastasis following laparoscopic tumor surgery.
BACKGROUND
The mechanisms involved in the development of port site metastasis following laparoscopic tumor surgery remain controversial. Therefore, we decided to investigate the influence of trocar placement and CO(2) pneumoperitoneum on abdominal wound implantation in relation to intraperitoneal tumor growth in a rabbit model.


METHODS
Rabbits received either CO(2) pneumoperitoneum with insertion of nine trocars (pneumoperitoneum group, n = 15), insertion of nine trocars alone (nonpneumoperitoneum group, n = 15), or nine abdominal incisions (control group, n = 13) 3 days after intraperitoneal inoculation of VX(2) cancer cells.


RESULTS
The frequency of overall wound implantation on day 17 in the pneumoperitoneum group (24.4%) and nonpneumoperitoneum group (27.4%) tended to be higher than that in the control group (15.3%) (p = 0. 06). There was no significant difference among the three groups in the growth of cancer nodules on the omentum.


CONCLUSIONS
The presence of a trocar may be a factor contributing to port site metastasis but CO(2) pneumoperitoneum appears not to be a factor.
Ishida
H
H
Department of Surgery, Saitama Medical Center, Saitama Medical School, 1981 Kamoda, Kawagoe, Saitama, 350-0885, Japan.
Murata
N
N
Yamada
H
H
Nomura
T
T
Shimomura
K
K
Fujioka
M
M
Idezuki
Y
Y
D000818:Animals; D002245:Carbon Dioxide; D010535:Laparoscopy; D008297:Male; D009366:Neoplasm Seeding; D010534:Peritoneal Neoplasms; D011028:Pneumoperitoneum, Artificial; D011817:Rabbits; D011897:Random Allocation; D013525:Surgical Instruments
D002245:Carbon Dioxide