The Pathogenesis of Port-Site Recurrences

被引：83

作者：

Reymond M.A. ^{[1
,2
]}

Schneider C. ^{[1
]}

Kastl S. ^{[1
]}

Hohenberger W. ^{[1
]}

Kockerling F. ^{[1
]}

机构：

[1] Department of Surgery, University of Erlangen, Erlangen

[2] Department of Surgery, University of Erlangen, D-91023 Erlangen

来源：

Journal of Gastrointestinal Surgery | 1998年 / 2卷 / 5期

关键词：

Colorectal Cancer; Advanced Tumor Stage; Wound Recurrence; Cell Hnes; Operative Spillage;

D O I：

10.1016/S1091-255X(98)80030-9

中图分类号：

学科分类号：

摘要：

The major factors underlying the seeding of tumor cells during laparoscopy are mechanical, with CO2 playing only a secondary role The peritoneal wound is of great importance, especially in advanced tumor stages, when cells are present within the abdominal cavity Most reported port-site metastases were found within the extraction port when no protective measures were taken Gasless laparoscopy is no solution to the problem, since numerous port-site metastases have been described after thoracoscopy, during which no CO2 is used The surgeon's role in the seeding of tumor cells is based on tumor perforation, excessive manipulation, and replacement of trocars This presumably explains the large differences (0% and 21%) in the reported incidence of port-site metastases Prospective studies now show that it is possible to keep the incidence of abdominal wall metastases to about 1% - which is comparable to that seen in open surgery - by the use of a meticulous operating technique and preventive measures.

引用

页码：406 / 414

页数：8

共 88 条

[1]

Trokel M.J., Bessler M., Treat M.R., Whelan R.L., Nowygrod R., Preservation of immune response after laparoscopy, Surg Endosc, 8, pp. 1385-1387, (1994)

[2]

Bessler M., Whelan R.L., Halverson A., Treat M.R., Nowygrod R., Is immune function better preserved after laparoscopic versus open colon resection?, Surg Endosc, 8, pp. 881-883, (1994)

[3]

Allendorf J.D.F., Bessler M., Whelan R.L., Trokel M., Laird D.A., Terry M.B., Treat M.R., Better preservation of immune function after laparoscopic-assisted vs open bowel resection in a murine model, Dis Colon Rectum, 39, (1996)

[4]

Nguyen N., Shurin M.R., Shatz S., Tran Q., Ravid J., Edwards J., Schauer P.R., The effect of open and laparoscopic surgery on cellular immunity, Surg Endosc, 11, (1997)

[5]

Bouvy N.D., Marquet R.L., Lambert S.W.J., Jeekel J., Bonjer H.J., Laparoscopic bowel resection in the rat: Earlier restoration of IGF-1 and less tumor growth, Surg Endosc, 10, (1996)

[6]

Mutter D., Hajri A., Tassetti C., Solis-Caxaj C., Aprahamian M., Marescaux J., Experimental pancreatic tumor growth and spread after laparoscopy versus laparotomy in the rat, Surg Endosc, 10, pp. 490-494, (1996)

[7]

Jacobi C.A., Ordermann J., Bohm B., Zieren H.U., Volk H.D., Muller J.M., Increased tumor growth after laparotomy and laparoscopy with air versus CO<sub>2</sub>, Surg Endosc, 10, (1996)

[8]

Bouvy N.D., Marquet R.L., Hamming J.F., Jeekel J., Bonjer H.J., Laparoscopic surgery in the rat Beneficial effect on body weight and tumor take, Surg Endosc, 10, pp. 490-494, (1996)

[9]

Allendorf J.D., Bessler M., Kayton M.L., Oesterling S.D., Treat M.R., Nowygrod R., Whelan R.L., Increased tumor establishment and growth after laparotomy vs laparoscopy in a murine model, Arch Surg, 130, pp. 649-653, (1995)

[10]

Allendorf B.A., Whelan R., Laird D., Horvath K., Marvin M., Bessler M., Absence of T cell function eliminates differences in tumor growth after open versus laparoscopic surgery in mice, Surg Endosc, 11, (1997)

← 1 2 3 4 5 6 7 8 9 →