Effect of port composition on tumor cell adherence: an in vivo model.
BACKGROUND
We have reported previously on an in vitro model to examine tumor cell adherence to metal and plastic laparoscopic ports and to port sites through which they had been passed. This demonstrated that increased numbers of tumor cells were found both on metal ports compared with plastic ports and on the port sites through which metal ports had passed. In this study, the in vivo adherence of such cells to ports and port sites was investigated.


METHODS
LIM 1215 tumor cells were injected under direct vision into the pelvises of 16 30-kg female pigs (range, 15-70 x 106 cells). A total of 12 ports were inserted through each anterior abdominal wall (6 metal and 6 plastic), and these were either left in situ for 30 minutes (nondisplaced) or were removed twice and replaced through the original wound (displaced).


RESULTS
Increasing the tumor cell inoculum resulted in increased deposition of tumor cells on both ports (P = 0.002) and on the port sites (P = 0.017). Significantly more tumor cells adhered to metal ports than to plastic ports (P = 0.04), although this failed to reach significance for the sites through which metal ports had been passed (P = 0.066). Although displacement of ports did not increase the number of tumor cells that adhered to ports (P = 0.45), this did result in more tumor cells being deposited on the port sites (P = 0.01).


CONCLUSIONS
These data suggest that minimizing the number of tumor cells within the abdominal cavity, using plastic ports, and securing ports to prevent inadvertent displacement would be expected to reduce the number of tumor cells deposited in port sites during operative laparoscopy. This may be beneficial in reducing the incidence of port-site metastases after laparoscopic surgery for gastrointestinal malignancies.
Brundell
Simeon
S
University of Adelaide, Division of Surgery, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
Tsopelas
Chris
C
Chatterton
Barry
B
Touloumtzoglou
Joanna
J
Blefari
Cristina
C
Hewett
Peter J
PJ
D000818:Animals; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D002448:Cell Adhesion; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D004866:Equipment Contamination; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications; D010535:Laparoscopy / Q000009:adverse effects*; D008670:Metals / Q000009:adverse effects*; D023421:Models, Animal; D009366:Neoplasm Seeding; D010969:Plastics / Q000009:adverse effects*; D013525:Surgical Instruments / Q000009:adverse effects*; D013552:Swine; D014407:Tumor Cells, Cultured
D008670:Metals; D010969:Plastics