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Influence of cytotoxic agents on intraperitoneal tumor implantation after laparoscopy

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Recent experimental studies suggest that laparoscopic surgery for abdominal malignancy may be associated with increased tumor implantation. This study investigated the influence of cytotoxic agents (administered intraperitoneally or intramuscularly) on implantation of a tumor cell suspension after laparoscopic surgery in an experimental model. METHODS: Thirty-three Dark Agouti rats underwent laparoscopy with CO2 insufflation and instillation of a tumor cell suspension into the abdominal cavity. Rats were randomly allocated to one of the following study groups (9 rats in the control group, 6 rats in all other groups): 1) control (no intraperitoneal instillation); 2) intraperitoneal normal saline (0.9 percent); 3) intraperitoneal povidoneiodine (Betadine® to normal saline 1:10 dilution); 4) intraperitoneal methotrexate (2 doses of 0.125 mg/kg body weight in normal saline administered 24 hours apart); 5) intramuscular injection of 2 doses of 0.125 mg/kg body weight administered 24 hours apart (no intraperitoneal agent). Rats were killed 7 days after the procedure, and the peritoneal cavity and port sites were examined for the presence of tumor. RESULTS: A significant reduction in tumor implantation and port-site metastases was observed in all treatment groups (povidone-iodine and intramuscular and intraperitoneal methotrexate). CONCLUSIONS: This study suggests that tumor implantation after laparoscopic surgery and port-site metastases might be prevented by the intraperitoneal or systemic administration of cytotoxic agents. Further studies are needed to determine whether these findings can be applied to clinical practice.

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Authors and Affiliations

  1. From The Royal Adelaide Centre for Endoscopic Surgery, Royal Adelaide Hospital, Australia

    Susan J. Neuhaus M.B.B.S. & David I. Watson M.D. (F.R.A.C.S.)

  2. University of Adelaide Department of Surgery, Royal Adelaide Hospital, Australia

    Tanya Ellis B.Sc. (Hons.) & Glyn G. Jamieson M.S. (F.R.A.C.S.)

  3. Institute of Medical and Veterinary Science, Adelaide, South Australia

    Allan M. Rofe Ph.D.

Authors
  1. Susan J. Neuhaus M.B.B.S.
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  2. David I. Watson M.D.
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  3. Tanya Ellis B.Sc. (Hons.)
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  4. Allan M. Rofe Ph.D.
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  5. Glyn G. Jamieson M.S.
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Additional information

Supported by a project grant from the National Health and Medical Research Council of Australia, the Olympus/Gastroenterological Society of Australia Postgraduate Scholarship in Endoscopic Research (SJN), and a grant from the Burnside War Memorial Hospital, Burnside, South Australia.

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Neuhaus, S.J., Watson, D.I., Ellis, T. et al. Influence of cytotoxic agents on intraperitoneal tumor implantation after laparoscopy. Dis Colon Rectum 42, 10–15 (1999). https://doi.org/10.1007/BF02235176

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