Intraperitoneal tumor growth is influenced by pressure of carbon dioxide pneumoperitoneum.
BACKGROUND
Several studies have indicated that the carbon dioxide (CO(2)) pneumoperitoneum during laparoscopy plays a role in the pathogenesis of port-site metastases. An experimental animal study was performed to investigate the impact of various pneumoperitoneum pressures on peritoneal tumor growth.


METHODS
In this study, 36 male WAG rats were randomized into three groups; two groups with different pneumoperitoneum pressures (16 mmHg and 4 mmHg) and one group of gasless controls. After a pneumoperitoneum of 0.5 x 10(6) ml was established, 531 tumor cells were injected intra-abdominally and the pneumoperitoneum was maintained for 60 min. Peritoneal tumor growth was assessed on day 11 at autopsy.


RESULTS
Peritoneal tumor growth in the 16-mmHg group was significantly greater than in the 4-mmHg group (p = 0.039) and the gasless group (p = 0.004).


CONCLUSIONS
High-pressure CO(2) pneumoperitoneum stimulates intra-abdominal tumor growth. The use of low insufflation pressures in laparoscopic cancer surgery should be considered.
Wittich
P
P
Department of Surgery, University Hospital Rotterdam-Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Steyerberg
E W
EW
Simons
S H
SH
Marquet
R L
RL
Bonjer
H J
HJ
D000818:Animals; D002245:Carbon Dioxide; D005069:Evaluation Studies as Topic; D008297:Male; D009366:Neoplasm Seeding; D010534:Peritoneal Neoplasms / Q000209:etiology*; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011312:Pressure; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar
D002245:Carbon Dioxide