title: Circulating tumour cells during laparoscopic and open surgery for primary colonic cancer in portal and peripheral blood.
abstract: BACKGROUND
  The objective of this study was to detect and quantify circulating tumour cells (CTC) in peripheral and portal blood of patients who had open or laparoscopic surgery for primary colonic cancer.
  
  
  METHODS
  Patients in the laparoscopic-group were operated on in a medial to lateral approach ("vessels first"), in the open-group a lateral to medial approach was applied. The enumeration of CTC was performed with the CellSearch System. Intra-operative samples were taken paired-wise (from peripheral and portal circulation) directly after entering the abdominal cavity (T1), after mobilisation of the tumour baring segment (T2), and after tumour resection (T3). Ploidy of both the CTC and tissue of the primary tumour was determined for chromosome 1, 7, 8 and 17.
  
  
  RESULTS
  Thirty-one patients were included; 18 patients had open surgery, 13 patients were operated on laparoscopically. The percentage of samples with CTC at T1 was 7% in peripheral blood and 54% in portal blood (p=0.002). At T2, 4% and 31% respectively (p=0.031). And at T3, 4% and 26% respectively (p=0.125). The cumulative percentage of samples with CTC was significantly higher during open surgery as compared to the laparoscopic approach. Both the CTC and tissue of the primary tumour were diploid for chromosome 1, 7, 8 and 17.
  
  
  CONCLUSIONS
  The detection rate and quantity of CTC is significantly increased intra-operatively and is significantly higher in portal blood compared to peripheral blood. Significantly less CTC were detected during laparoscopic surgery probably as result of the medial to lateral approach.
authors.affiliation: Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Wind
authors.forename: J B
authors.initials: JB
authors.lastname: Tuynman
authors.forename: A G J
authors.initials: AG
authors.lastname: Tibbe
authors.forename: J F
authors.initials: JF
authors.lastname: Swennenhuis
authors.forename: D J
authors.initials: DJ
authors.lastname: Richel
authors.forename: M I
authors.initials: MI
authors.lastname: van Berge Henegouwen
authors.forename: W A
authors.initials: WA
authors.lastname: Bemelman
mesh_terms: D000368:Aged; D001800:Blood Specimen Collection / Q000379:methods; D002452:Cell Count; D003082:Colectomy / Q000379:methods; D003110:Colonic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009360:Neoplastic Cells, Circulating / Q000378:metabolism* / Q000473:pathology; D009426:Netherlands