Document Detail


Excision of laparoscopic port sites increases the likelihood of wound metastases in an experimental model.
MedLine Citation:
PMID:  12360378     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Case reports of patients developing tumor metastases at port sites following laparoscopic surgery have prompted the development of preventive strategies to address this potential problem, including local excision of the port sites. While it has been suggested that this strategy could be used clinically, its efficacy has not been established. METHODS: Twenty four immune-competent Dark Agouti rats underwent laparoscopy and standardized intraperitoneal laceration of an implanted abdominal flank tumor, using an established laparoscopic cancer model. Rats were randomized to either control (n = 12) or wound excision (n = 12) groups. Both groups underwent laparoscopy using carbon dioxide (CO2) insufflation and two mini-laparoscopy ports. In the wound excision group, one of the port site wounds was excised following desufflation of the abdominal cavity. One week later, the port site wounds were excised for histological examination. RESULTS: Wound involvement with tumor was significantly more common following wound excision than with untreated control wounds (nine of 12 vs two of 12, p = 0.002). In the wound excision group, tumor metastases arose preferentially in the excised port site wound. CONCLUSION: This study suggests that excision of laparoscopy port site wounds following laparoscopic surgery for cancer does not prevent the subsequent development of port site tumors. Furthermore, the excision of port sites may actually increase the risk of tumor metastases arising in port sites, suggesting that the clinical application of this strategy should be avoided pending further evaluation.
Authors:
D I Watson; T Ellis; P C Leeder; S J Neuhaus; T Dodd; G G Jamieson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2002-09-30
Journal Detail:
Title:  Surgical endoscopy     Volume:  17     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-02-06     Completed Date:  2003-03-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  83-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, Royal Adelaide Hospital, The University of Adelaide, Adelaide, South Australia 5000, Australia. david.watson@flinders.edu.au
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MeSH Terms
Descriptor/Qualifier:
Abdominal Neoplasms / surgery
Adenocarcinoma / surgery
Animals
Insufflation / adverse effects
Laparoscopy / adverse effects*
Male
Mammary Neoplasms, Experimental / surgery
Neoplasm Seeding*
Neoplasm Transplantation
Rats
Wounds, Stab / complications*,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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