Increased tumor growth after high pressure pneumoperitoneum with helium and air.
BACKGROUND
Tumor growth appears proportional to the pressure of carbon dioxide insufflation during laparoscopic surgery. Air and helium are alternative insufflation gases. The objective of this study is to assess tumor growth after air and helium insufflation at different pressures.


METHODS
Ninety-six WAG rats were allocated to either air or helium. In both arms, rats were randomly exposed to a one hour gasless procedure, or to 4 mm Hg, 10 mm Hg, or 16 mm Hg insufflation. At the start of the procedure, 500,000 CC531 tumor cells were injected intraperitoneally. After three weeks, intraperitoneal tumor growth was assessed.


RESULTS
Higher insufflation pressures were associated with greater tumor growth. No difference of tumor growth between air and helium insufflation was found.


CONCLUSIONS
In this experimental model, insufflation pressure appeared to have a greater impact on tumor growth than the type of gas. Further studies are necessary but it seems prudent to recommend employment of lower insufflation pressures in laparoscopic oncologic surgery.
Wittich
Philippe
P
MCRZ, St. Clara Hospital, Rotterdam, The Netherlands.
Mearadji
Amir
A
Marquet
Richard L
RL
Bonjer
H Jaap
HJ
D000388:Air; D000818:Animals; D006371:Helium; D009366:Neoplasm Seeding; D010534:Peritoneal Neoplasms / Q000209:etiology*; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects* / Q000379:methods*; D051381:Rats; D011919:Rats, Inbred Strains
D006371:Helium