Irrigation of port sites: prevention of port site metastases?
BACKGROUND
Port site metastases can occur when free viable tumor cells implant at trocar wounds. Irrigation of port sites with cytotoxic agents has been suggested to prevent port site metastases. The objective of this study is to assess whether tumor growth at port sites can be reduced by irrigation of these port sites.


METHODS
WAG rats were insufflated with CO(2) for 20 minutes and 5 x 10(5) CC531 tumor cells were injected intraperitoneally. Port sites were irrigated after completion of the pneumoperitoneum with povidone-iodine, a mixture of taurolidine and heparin, or sodium chloride. Controls did not undergo any irrigation of port sites. In experiment 1, all 16 rats had all 4 irrigation modalities. In experiment 2, four groups of 20 rats had one type of irrigation on two trocar wounds. Tumor growth was evaluated 4 weeks after the procedure.


RESULTS
No difference in tumor growth at trocar wounds was found between any type of irrigation and controls in both experiments.


CONCLUSIONS
In this experimental model, no beneficial or adverse effects of irrigation of port sites could be shown.
Wittich
Philippe
P
Department of Surgery, MCRZ, St. Clara Hospital, Rotterdam, The Netherlands.
Mearadji
Amir
A
Marquet
Richard L
RL
Bonjer
H Jaap
HJ
D000230:Adenocarcinoma / Q000473:pathology; D000818:Animals; D006493:Heparin / Q000008:administration & dosage; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D009366:Neoplasm Seeding; D009368:Neoplasm Transplantation; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects / Q000379:methods*; D011206:Povidone-Iodine / Q000008:administration & dosage; D011677:Punctures / Q000009:adverse effects*; D051381:Rats; D011919:Rats, Inbred Strains; D012965:Sodium Chloride / Q000008:administration & dosage; D013654:Taurine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007507:Therapeutic Irrigation; D013829:Thiadiazines / Q000008:administration & dosage
D013829:Thiadiazines; D013654:Taurine; D012965:Sodium Chloride; D011206:Povidone-Iodine; C012566:taurolidine; D006493:Heparin