Abstract
Background: Laparoscopy in patients with intra-abdominal malignancy remains controversial. This
study evaluates the incidence of tumor recurrence at the port site after laparoscopy
in patients with intra-abdominal malignancy. Methods: The medical records of all patients with nongynecologic malignancies who underwent
laparoscopic procedures between May 1, 1990, and June 30, 1996, at the University
of Texas M.D. Anderson Cancer Center were reviewed. Data on extent of tumor, histologic
findings, primary location, procedures performed, and complications were recorded.
Results: During this time, 533 patients with known intra-abdominal malignancies underwent
laparoscopy. Mean follow-up time was 13.2 ± 0.5 months (range 1 to 71 months; median
10.6 months). Four recurrences at the port site were identified (0.8%). Three of these
patients had advanced intra-abdominal disease at the time of laparoscopy; 1 patient
without advanced disease at the time of laparoscopy had a recurrence at the port site
as the only site of recurrent disease (0.19%). The incidence of port site recurrences
among patients with advanced intra-abdominal disease at the time of laparoscopy (3/71)
was significantly greater than the risk of development of a recurrence at the port
site among patients without advanced intra-abdominal disease at the time of laparoscopy
(1/462; P < .0003, by chi-square analysis). Conclusion: Recurrence at the port site is very rare. When implantation at the port site does
occur, it is most commonly associated with advanced intra-abdominal disease. (Surgery
1999;125:67--72.)
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
- Abdominal wall metastasis following laparoscopy: a case report.Eur J Surg Oncol. 1985; 11: 373-375
- Tumor implantation after diagnostic laparoscopic biopsy of serous ovarian tumors of low malignant potential.Obstet Gynecol. 1986; 68: 90
- Subcutaneous metastasis following laparoscopy in gastric adenocarcinoma.Eur J Surg Oncol. 1990; 16: 63-67
- Rapid development of malignant metastasis in the abdominal wall after laparoscopy.Endoscopy. 1978; 10: 127-130
- Cutaneous seeding of gallbladder cancer after laparoscopic cholecystectomy [letter].N Engl J Med. 1991; 325: 1316
- Parietal seeding of carcinoma of the gallbladder after laparoscopic cholecystectomy.Br J Surg. 1992; 79: 230
- Unusual relapse of hepatocellular carcinoma.Cancer. 1992; 70: 1483-1487
- Laparoscopically assisted colectomy and wound recurrence [letter].Lancet. 1993; 341: 249
- Abdominal wall metastases from ovarian cancer after laparoscopy.Am J Obstet Gynecol. 1993; 169: 522-523
- Rapid development of umbilical metastases after laparoscopic cholecystectomy for unsuspected gallbladder carcinoma.Surgery. 1993; 113: 355-358
- Laparoscopic surgery and tumor seeding [letter].Surgery. 1993; 114: 131-132
- Cutaneous tumor seeding from a previously undiagnosed pancreatic carcinoma after laparoscopic cholecystectomy.Ann R Coll Surg Engl. 1993; 75: 199-200
- Gallbladder cancer discovered during laparoscopic surgery: potential for iatrogenic tumor dissemination.Arch Surg. 1993; 128: 1054-1056
- Abdominal wall recurrence after laparoscopic-assisted colectomy for adenocarcinoma of the colon.Dis Colon Rectum. 1993; 36: 858-861
- Tumor inoculation during laparoscopy.Lancet. 1993; 342 ([letter]): 368
- Tumor inoculation during laparoscopy [letter].Lancet. 1993; 342: 368-369
- Subcutaneous metastases after laparoscopic resection of malignancy.Aust N Z J Surg. 1993; 63: 563-565
- Laparoscopy and colon cancer: is the port site at risk? A preliminary report.Arch Surg. 1994; 129: 897-899
- Abdominal wall metastases following laparoscopy [letter].Br J Surg. 1994; 81: 1693
- Subcutaneous metastases after laparoscopic colectomy [letter].Lancet. 1994; 344: 58
- Abdominal wall recurrence after laparoscopic colectomy for colon cancer.Surgery. 1994; 116: 842-846
- Abdominal wall metastases following laparoscopy.Br J Surg. 1994; 81: 648-652
- Port site seeding after laparoscopic ultrasonographic staging of pancreatic carcinoma [letter].Surgery. 1995; 117: 118-119
- Port-site metastases in patients undergoing laparoscopy for gastrointestinal malignancy.Br J Surg. 1996; 83: 1419-1420
- Port site metastasis after laparoscopic-assisted vaginal hysterectomy for endometrial cancer: possible mechanisms and prevention.Gynecol Oncol. 1997; 66: 151-155
- The influence of surgical trauma on experimental metastasis.Cancer. 1989; 64: 2035-2044
- Viability of exfoliated colorectal carcinoma cells.Br J Surg. 1984; 71: 659-663
- Intraperitoneal free cancer cells and their viability in gastric cancer.Cancer. 1986; 58: 1609-1620
- Tumor recurrence in the abdominal wall scar after large bowel cancer surgery.Dis Colon Rectum. 1983; 26: 571-572
- Implantation of gastric cancer in abdominal wounds.Ann Surg. 1960; 152: 789-794
- Recurrent malignant disease in operative wounds not due to surgical implantation from the resected specimen.Surgery. 1965; 58: 806-809
- Trauma and the localization of tumor cells.Cancer. 1967; 20: 23-30
- Mikulicz operation for resection of the colon: its advantages and dangers.Ann Surg. 1928; 88: 597-606
- Small contributions to the surgery of the intestinal tract.Boston Med Surg J. 1903; 148: 608-611
- Personal experiences in surgery of the large bowel.Lancet. 1912; 2: 217-226
- Gallbladder cancer and trocar site recurrences.Am J Surg. 1997; 174: 619-623
- A proposed model for the movement of cells within the abdominal cavity during CO2 insufflation and laparoscopy.Aust NZ J Surg. 1996; 66: 105-106
- Increased tumor establishment and growth after laparotomy vs laparoscopy in a murine model.Arch Surg. 1995; 130: 649-653
- Tumor growth after laparotomy or laparoscopy.Surg Endosc. 1995; 9: 49-52
- Gasless laparoscopy may reduce the risk of port-site metastases following laparoscopic tumor surgery.Arch Surg. 1997; 132: 166-168
- Impact of pneumoperitoneum on trocar site implantation of colon cancer in hamster model.Dis Colon Rectum. 1995; 38: 1182-1188
- Implantation of colon cancer at trocar sites is increased by low pressure pneumoperitoneum.Surgery. 1997; 122: 1-7
- Impact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdominal wall metastases.Ann Surg. 1996; 224: 694-701
- The effect of peritoneal air exposure on postoperative tumor growth.Surg Endosc. 1998; 12: 348-350
- Increased tumor establishment and growth after laparotomy versus laparoscopy in a murine model.Arch Surg. 1995; 130: 649-653
- Association of local recurrence with subsequent survival in extremity soft tissue sarcoma.J Clin Oncol. 1997; 15: 646-652
Article info
Publication history
Accepted:
July 7,
1998
Footnotes
☆Reprint requests: Barry W. Feig, MD, Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.
Identification
Copyright
© 1999 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
