Pneumoperitoneum does not influence trocar site implantation during tumor manipulation in a solid tumor model.
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.
Halpin
V J
VJ
Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8109, St. Louis, MO 63110, USA. halpinv@msnotes.wustl.edu
Underwood
R A
RA
Ye
D
D
Cooper
D H
DH
Wright
M
M
Hickerson
S M
SM
Connett
W C
WC
Connett
J M
JM
Fleshman
J W
JW
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*