Abstract
Background
We recently demonstrated that CO2 pneumoperitoneum at low intraperitoneal pressure (IPP) had few if any short-term effects on peritoneal dissemination when an ovarian cancer cell line was inoculated just prior to surgery. The objective of the present study was to evaluate the impact of surgical peritoneal environment on postoperative tumor growth and dissemination over time when tumors were present before surgery.
Methods
On day-7, C57BJ6 mice received an intraperitoneal inoculation of a mouse ovarian cancer cell line (ID8). On day 0, mice were randomized into four groups: anesthesia alone, CO2 pneumoperitoneum at a low (2 mmHg) or high (8 mmHg) IPP, or laparotomy. Groups were further subdivided into four groups of eight animals each and a laparotomy was performed to evaluate dissemination on postoperative day (POD) 1, 2, 7 or 14.
Results
Peritoneal dissemination score was significantly higher in the laparotomy group compared with in the remaining three groups on PODs 2 and 7. We detected no significant differences in the peritoneal dissemination scores among the low-IPP, high-IPP, and anesthesia groups on PODs 2 and 7. However, there were no significant differences in the peritoneal dissemination score among the three surgical groups on POD 14. Histopathological examination demonstrated that the incidence of invasion of cancer cells into the muscle layers was significantly higher in the laparotomy group than in the low-IPP and anesthesia groups on POD 14. There were no significant differences in tumor growth among the four groups.
Conclusions
The present findings suggest that CO2 pneumoperitoneum at either high or low IPP has few if any short-term effects on peritoneal dissemination when tumors are well established before surgery.
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Acknowledgments
We are indebted to all staff in the Centre International de la Chirurgie Endoscopique (Clermont-Ferrand, France) and technicians in the Department of Anatomie et Cytologie Pathologiques, CHU Clermont-Ferrand, Hôtel-Dieu, for technical support. We are indebted to Karl Storz Endoscopy GmbH (Tuttlingen, Germany) and Organon (Paris, France) for providing laparoscopic equipments and vecuronium bromide, respectively.
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This study was supported in part by la Ligue Régionale de Lutte contre le Cancer (Auvergne region, France) and Karl Storz Endoscopy GmbH (Tuttlingen, Germany).
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Azuar, AS., Matsuzaki, S., Darcha, C. et al. Impact of surgical peritoneal environment on postoperative tumor growth and dissemination in a preimplanted tumor model. Surg Endosc 23, 1733–1739 (2009). https://doi.org/10.1007/s00464-008-0174-8
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DOI: https://doi.org/10.1007/s00464-008-0174-8