Abstract
Background. In patients with primary colorectal cancer, liver metastases are the most important
indicators of prognosis and survival; the effect of laparoscopic surgery on the development
of hepatic tumor spread is still largely unknown. Methods. Thirty WAG/Rij rats were randomly divided into 3 operative groups for intraportal
tumor cell inoculation: carbon dioxide pneumoperitoneum (group I, n = 10), gasless
laparoscopy (group II, n = 10) and open laparotomy (group III, n = 10). The total
operating time was 90 minutes with tumor cell injection (50,000 CC531 colon carcinoma
cells/mL) performed 45 minutes after the start of the procedure. Hepatic tumor growth
and the total tumor load were evaluated 28 days after surgery. Results. Hepatic tumor growth and total tumor load were significantly reduced in the gasless
laparoscopy group (group II) as compared with the carbon dioxide pneumoperitoneum
group (group I) and the open laparotomy group (group III) (P <.05). No significant difference was found between the carbon dioxide and the open
laparotomy groups. Conclusions. Insufflation of carbon dioxide may actually stimulate metastatic disease of the liver.
Gasless laparoscopy seems to preserve hepatic resistance against tumor growth. (Surgery
2000;127:566–70.)
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Article info
Publication history
Accepted:
December 5,
1999
Footnotes
*Reprint requests: Carsten N. Gutt, MD, Department of General and Vascular Surgery, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
**Surgery 2000;127:566–70
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
