BACKGROUND: Several studies have indicated that the carbon dioxide (CO(2)) pneumoperitoneum during laparoscopy plays a role in the pathogenesis of port-site metastases. An experimental animal study was performed to investigate the impact of various pneumoperitoneum pressures on peritoneal tumor growth. METHODS: In this study, 36 male WAG rats were randomized into three groups; two groups with different pneumoperitoneum pressures (16 mmHg and 4 mmHg) and one group of gasless controls. After a pneumoperitoneum of 0.5 x 10(6) ml was established, 531 tumor cells were injected intra-abdominally and the pneumoperitoneum was maintained for 60 min. Peritoneal tumor growth was assessed on day 11 at autopsy. RESULTS: Peritoneal tumor growth in the 16-mmHg group was significantly greater than in the 4-mmHg group (p = 0.039) and the gasless group (p = 0.004). CONCLUSIONS: High-pressure CO(2) pneumoperitoneum stimulates intra-abdominal tumor growth. The use of low insufflation pressures in laparoscopic cancer surgery should be considered.
BACKGROUND: Several studies have indicated that the carbon dioxide (CO(2)) pneumoperitoneum during laparoscopy plays a role in the pathogenesis of port-site metastases. An experimental animal study was performed to investigate the impact of various pneumoperitoneum pressures on peritoneal tumor growth. METHODS: In this study, 36 male WAG rats were randomized into three groups; two groups with different pneumoperitoneum pressures (16 mmHg and 4 mmHg) and one group of gasless controls. After a pneumoperitoneum of 0.5 x 10(6) ml was established, 531 tumor cells were injected intra-abdominally and the pneumoperitoneum was maintained for 60 min. Peritoneal tumor growth was assessed on day 11 at autopsy. RESULTS: Peritoneal tumor growth in the 16-mmHg group was significantly greater than in the 4-mmHg group (p = 0.039) and the gasless group (p = 0.004). CONCLUSIONS: High-pressure CO(2) pneumoperitoneum stimulates intra-abdominal tumor growth. The use of low insufflation pressures in laparoscopic cancer surgery should be considered.
Authors: R Veldkamp; M Gholghesaei; H J Bonjer; D W Meijer; M Buunen; J Jeekel; B Anderberg; M A Cuesta; A Cuschierl; A Fingerhut; J W Fleshman; P J Guillou; E Haglind; J Himpens; C A Jacobi; J J Jakimowicz; F Koeckerling; A M Lacy; E Lezoche; J R Monson; M Morino; E Neugebauer; S D Wexner; R L Whelan Journal: Surg Endosc Date: 2004-06-23 Impact factor: 4.584
Authors: Amit D Raval; Sohan Deshpande; Maria Koufopoulou; Silvia Rabar; Binod Neupane; Ike Iheanacho; Lori D Bash; Jay Horrow; Thomas Fuchs-Buder Journal: Surg Endosc Date: 2020-04-06 Impact factor: 4.584