Abstract
Background. Laparoscopic surgery is now applied to patients with gastrointestinal cancer. In
animal studies, extraperitoneal tumor growth has been significantly less after laparoscopy
than after laparotomy, but whether hematogenous metastasis occurs less frequently
after laparoscopy is unknown. The aim of this study was to compare the frequency and
growth of lung metastasis and serum levels of IL-6 and tumor necrosis factor-α (TNF-α)
in mice treated by laparotomy and in mice treated by laparoscopy. Methods. We used 182 male BALB/c mice. Colon 26 cancer cells (5 × 104) were injected into the tail vein, and the mice were assigned to a laparotomy group
(3-cm laparotomy), a laparoscopy group (carbon dioxide pneumoperitoneum at 6 to 8
mm Hg for 30 minutes), or a control group. Lung weight, number of lung metastases,
and serum levels of IL-6 and TNF-α were measured and compared among the 3 groups.
Results. The lung weight and number of metastases on the lung surface and cut section in the
laparotomy group (0.44 ± 0.21 g, 55.7 ± 46.7, 23.0 ± 19.0) were significantly larger
than those in the laparoscopy group (0.32 ± 0.15 g, 29.9 ± 25.5, 13.1 ± 9.9) or the
control group (0.28 ± 0.13, 29.3 ± 26.2, 11.1 ± 11.1). Three hours after the procedures,
the serum level of IL-6 was significantly higher in the laparotomy group (1353 ± 790
pg/mL) than in the laparoscopy group (671 ± 353 pg/mL) or the control group (333 ±
341 pg/mL). The lung weight, number of lung metastases, and levels of IL-6 and TNF-α
were not different between the laparoscopy and control groups. Conclusions. Our results indicate that, although laparotomy accelerates tumor metastasis to the
lung in this murine model, laparoscopy does not increase the frequency and growth
of lung metastasis. The laparoscopic approach may suppress hematogenous metastasis
to the lung because of decreased surgical stress and reduced cytokine response. (Surgery
2000;128:799-805.)
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Laparoscopic approaches in the management of patients with early gastric carcinomas.Surg Laparosc Endosc. 1995; 5: 359-362
- Laparoscopic resection does not adversely affect early survival curves in patients undergoing surgery for colorectal adenocarcinoma.Ann Surg. 1999; 229: 487-492
- Laparoscopic-assisted resection of colorectal carcinoma: five-year audit.Dis Colon Rectum. 1999; 42: 327-333
- A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report.J Am Coll Surg. 1998; 187: 46-57
- Indication for and outcome of laparoscopy-assisted Billroth I gastrectomy.Br J Surg. 1999; 86: 541-544
- Quality of life after laparoscopy-assisted Billroth I gastrectomy.Ann Surg. 1999; 229: 49-54
- Port site metastases after laparoscopic colorectal surgery for cure of malignancy [review].Br J Surg. 1995; 82: 295-298
- Port-site metastases following laparoscopic surgery [review].Br J Surg. 1998; 85: 735-741
- Impact of pneumoperitoneum on trocar site implantation of colon cancer in hamster model.Dis Colon Rectum. 1995; 38: 1182-1188
- Wound metastases following laparoscopic and open surgery for abdominal cancer in a rat model.Br J Surg. 1996; 83: 1087-1090
- Increased tumor establishment and growth after laparotomy vs laparoscopy in a murine model.Arch Surg. 1995; 130: 649-653
- Laparoscopic surgery is associated with less tumour growth stimulation than conventional surgery: an experimental study.Br J Surg. 1997; 84: 358-361
- Laparotomy and laparoscopy differentially accelerate experimental flank tumour growth.Br J Surg. 1998; 85: 1439-1442
- Evaluation of operative stress and peritoneal macrophage function in minimally invasive operations.J Am Coll Surg. 1997; 184: 357-363
- The effect of laparotomy and laparoscopy on the establishment of spontaneous tumor metastases.Surgery. 1998; 124: 516-525
- In vivo induction of murine cytokine production by carcinoembryonic antigen.Cancer Res. 1997; 57: 4432-4436
- Epinephrine and endotoxin tolerance differentially modulate serum cytokine levels to high-dose lipopolysaccharide challenge in a murine model.Surgery. 1999; 125: 403-410
- Convenient murine pneumoperitoneal model for the study of laparoscopic cancer surgery.Surg Laparosc Endosc. 1999; 9: 279-281
- Laparoscopic surgery and the systemic immune response [review].Ann Surg. 1998; 227: 326-334
- Prospective randomized study of laparoscopic versus open colonic resection for adenocarcinoma.Br J Surg. 1997; 84: 391-396
- Effects of carbon dioxide pneumoperitoneum, air pneumoperitoneum, and gasless laparoscopy on body weight and tumor growth.Arch Surg. 1998; 133: 652-656
- Mechanism of decreased in vitro murine macrophage cytokine release after exposure to carbon dioxide: relevance to laparoscopic surgery.Ann Surg. 1997; 226: 179-190
- Minimal modulation of lymphocyte and natural killer cell subsets following minimal access surgery.Am J Surg. 1999; 177: 48-54
- Peritoneal host defenses are less impaired by laparoscopy than by open operation.Surg Laparosc. 1995; 9: 1059-1064
- Complementary DNA for a novel human interleukin (BSF-2) that induces B cell lymphocytes to produce immunoglobulin.Nature. 1986; 324: 73-76
- Interleukin-6 as a new indicator of inflammatory status: detection of serum levels of interleukin-6 and c-reactive protein after surgery.Surgery. 1992; 111: 201-209
- Systemic cytokine response after major surgery.Br J Surg. 1992; 79: 757-760
- Detection of circulating tumor necrosis factor after endotoxin administration.N Engl J Med. 1988; 318: 1481-1486
- Production of interleukin-6 at operative wound sites in surgical patients.J Am Coll Surg. 1994; 179: 326-332
- Interleukin-6 response to laparoscopic and open colectomy.Dis Colon Rectum. 1994; 37: 754-759
- Hormone-cytokine response: pneumoperitoneum vs abdominal wall-lifting in laparoscopic cholecystectomy.Surg Endosc. 1997; 11: 907-910
- Mechanisms involved in metastasis enhanced by inflammatory mediators.Circ Shock. 1994; 44: 9-13
- Interleukin-6 production by rat hepatocellular carcinoma cells is associated with metastatic potential but not with tumorigenicity.Arch Surg. 1996; 131: 360-365
- Serum interleukin-6 level reflects the tumor proliferative activity in patients with colorectal carcinoma.Cancer. 1999; 85: 2526-2531
- Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells.Surgery. 1997; 121: 72-78
- Tumor implantation following laparoscopy using different insufflation gases.Surg Endosc. 1998; 12: 1300-1302
- Experimental study of the effect of intra-abdominal pressure during laparoscopy on tumour growth and port site metastasis.Br J Surg. 1998; 85: 1419-1422
Article info
Publication history
Accepted:
April 15,
2000
Footnotes
*Supported by a Grant-in-Aid for Scientific Research (B) from the Ministry of Education (#10470244) in Japan.
**Reprint requests: Seigo Kitano, MD, Department of Surgery I, Oita Medical University, 1-1 Idaigaoka, Hasama-machi, Oita 879-5593, Japan.
★Surgery 2000;128:799-805.
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
