Port site metastases: where are we at the beginning of the 21st century?
Following the introduction of minimal invasive surgery in the field of malignant disease, a number of reports have been published describing the occurrence of tumour deposits in the abdominal or thoracic wall at the sites of trocar placement. These trocar site metastases have caused great concern among minimal invasive surgeons and have put an important restraint on the rapid development of these techniques in oncologic surgery. The present review article focuses on the clinical facts and experimental studies that have been conducted on the problem of port site metastases, more specifically upon their occurrence and pathogenesis. Although most of the port site recurrences are due to technical surgical problems and can be avoided by adapting the same oncologic surgical principles as in open surgery, some features of the minimal invasive techniques facilitate tumour growth and should be kept in mind when performing minimum invasive surgery for malignancy.
Hubens
G
G
Dept of Abdominal Surgery, University Hospital of Antwerp. guy.hubens@uza.be
D000008:Abdominal Neoplasms / Q000517:prevention & control / Q000556:secondary*; D000818:Animals; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D009366:Neoplasm Seeding; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013899:Thoracic Neoplasms / Q000517:prevention & control / Q000556:secondary*