title: Pneumoperitoneum does not influence trocar site implantation during tumor manipulation in a solid tumor model.
abstract: BACKGROUND
  The purpose of this study was to assess tumor implantation at abdominal wound sites following manipulation of a solid abdominal tumor.
  
  
  METHODS
  GW-39 human colon cancer cells were injected into the omentum of golden Syrian hamsters. At 2 weeks, an omental tumor was harvested and animals were randomized to bivalve (A), crush (B), strip (C), or excision (D), with or without pneumoperitoneum. Four 5-mm trocars were inserted into the abdomen, and the tumor was reinserted through the midline, swept through four quadrants, and removed. The incision was closed and pneumoperitoneum at 7 mmHg was maintained for 10 min. Tumor implantation at wound sites was documented at 7 weeks.
  
  
  RESULTS
  Implantation at trocar sites was 53 and 49% with and without pneumoperitoneum in the manipulated groups (A, B, C), respectively (p = 0.993). Implantation at trocar sites was reduced in the control group (D) at 9 and 10% with and without pneumoperitoneum, respectively (p < 0.001).
  
  
  CONCLUSIONS
  Tumor implantation at trocar sites is due to spillage of tumor during manipulation and not to pneumoperitoneum.
authors.affiliation: Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8109, St. Louis, MO 63110, USA. halpinv@msnotes.wustl.edu
authors.forename: V J
authors.initials: VJ
authors.lastname: Halpin
authors.forename: R A
authors.initials: RA
authors.lastname: Underwood
authors.forename: D
authors.initials: D
authors.lastname: Ye
authors.forename: D H
authors.initials: DH
authors.lastname: Cooper
authors.forename: M
authors.initials: M
authors.lastname: Wright
authors.forename: S M
authors.initials: SM
authors.lastname: Hickerson
authors.forename: W C
authors.initials: WC
authors.lastname: Connett
authors.forename: J M
authors.initials: JM
authors.lastname: Connett
authors.forename: J W
authors.initials: JW
authors.lastname: Fleshman
mesh_terms: D000818:Animals; D045744:Cell Line, Tumor; D003110:Colonic Neoplasms / Q000556:secondary* / Q000601:surgery*; D006224:Cricetinae; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008647:Mesocricetus; D009366:Neoplasm Seeding; D009368:Neoplasm Transplantation; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*