Skip to main content

Advertisement

SpringerLink
Log in

Enhancement of port site metastasis by hyaluronic acid under CO2 pneumoperitoneum in a murine model

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The mechanism underlying the development and progression of port site metastasis after laparoscopic surgery for cancer is still not understood. Hyaluronic acid secreted from mesothelial cells is thought to be a key factor that causes adhesion between cancer cells and mesothelial cells. Using a murine model of carbon dioxide (CO2) pneumoperitoneum, we evaluated the effect of exogenous hyaluronic acid on port site metastasis.

Methods

BALB/c mice were injected with 5×106 human gastric carcinoma (MKN45) cells and divided into four groups treated with or without hyaluronic acid and with or without pneumoperitoneum. Three weeks later, the frequency and weight of port site metastases were determined. The effects of hyaluronic acid on tumorigenicity and tumor with MKN45 cells.

Results

Port site metastasis occurred significantly less frequently in the pneumoperitoneum-only group than in the pneumoperitoneum-with-hyaluronic-acid group (75% vs 100%, p<0.05). The port site metastatic tumor weighed significantly less in the control group (anesthesia only) than in the hyaluronic acid group (89±17 vs 288±35mg, p<0.05); it also weighed less in the pneumoperitoneum-only group than in the pneumoperitoneum-with-hyaluronic-acid group (87±24 vs 298±51 mg, p<0.05). The frequency and weight of tumors in the subcutaneous tissue were not significantly different between groups with or without hyaluronic acid injection (95% vs 90%, 331±128 vs 322±115 mg).

Conclusions

Under CO2 pneumoperitoneum, exogenous hyaluronic acid increased the frequency and weight of port site metastasis in a murine model. Hyaluronic acid secreted from mesothelial cells may be associated with the formation of port site metastasis after laparoscopic surgery for cancer under pneumoperitoneum.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S, Akazawa K (1999) Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg 229: 49–54

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Allardyce RA, Morreau P, Bagshaw PF (1997) Operative factors affecting tumor cell distribution following laparoscopic colectomy in a porcine model. Dis Colon Rectum 40: 939–945

    Article  CAS  PubMed  Google Scholar 

  3. Allendorf JDF, Bessler M, Kayton ML, Oesterling SD, Treat MR, Nowygrod R, Whelan RL (1995) Increased tumor establishment and growth after laparotomy vs laparoscopy in a murine model. Arch Surg 130: 649–653

    Article  CAS  PubMed  Google Scholar 

  4. Bouvy ND, Marquet RL, Jeekel H, Bonjer HJ (1996) Impact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdminal wall metastases. Ann Surg 224: 694–701

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Breborowicz A, Rodela H, Karon J, Martis L, Oreopoulos DG (1997) In vitro simulation of the effect of peritoneal dialysis solution on mesothelial cells. Am J Kidney Dis 29: 404–409

    Article  CAS  PubMed  Google Scholar 

  6. Hewett PJ, Thomas WM, King G, Eaton M (1996) Intraperitoneal cell movement during abdominal carbon dioxide insufflation and laparoscopy: an in vivo model. Dis Colon Rectum 39: S62-S66

    Article  CAS  PubMed  Google Scholar 

  7. Hillerdal G, Lindqvist U, Engström-Laurent A (1991) Hyaluronan in pleural effusion and in serum. Cancer 67: 2410–2414

    Article  CAS  PubMed  Google Scholar 

  8. Jacobi CA, Sabat R, Böhm B, Zieren HU, Volk HD, Müller JM (1997) Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells. Surgery 121: 72–78

    Article  CAS  PubMed  Google Scholar 

  9. Kitano S, Shimoda K, Miyahara M, Shiraishi N, Bandoh T, Yoshida T, Shuto K, Kobavashi M (1995) Laparoscopic approaches in the management of patients with early gastric carcinomas. Surg Laparosc Endosc 5: 359–362

    CAS  PubMed  Google Scholar 

  10. Knolmayer TJ, Asbun HJ, Shibata G, Bowyer MW (1997) An experimental model of cellular aerosolization during laparoscopic surgery. Surg Laparosc Endosc 7: 399–402

    Article  CAS  PubMed  Google Scholar 

  11. Martínez-Serna T, Stalter KD, Filipi CJ, Tomonaga T (1998) An unusual case of endometrial trocar site implantation. Surg Endosc 12: 992–994

    Article  PubMed  Google Scholar 

  12. Nduka CC, Monson JRT, Menzies-Gow N, Darzi A (1994) Abdominal wall metastases following laparoscopy. Br J Surg 81: 648–652

    Article  CAS  PubMed  Google Scholar 

  13. Neuhaus SJ, Texler M, Hewett PJ, Watson DI (1998) Port-site metastases following laparoscopic surgery. Br J Surg 85: 735–741

    Article  CAS  PubMed  Google Scholar 

  14. Neuhaus SJ, Watson DI, Ellis T, Rowland R, Rofe AM, Pike GK, Mathew G, Jamiesn GG (1998) Wound metastasis after laparoscopy with different insufflation gases. Surgery 123: 579–583

    Article  CAS  PubMed  Google Scholar 

  15. Nishimura S, Chung YS, Yashiro M, Inoue T, Sowa M (1996) CD44H plays an important role in peritoneal dissemination of scirrhous gastric cancer cells. Jpn J Cancer Res 87: 1235–1244

    Article  CAS  PubMed  Google Scholar 

  16. Oksala O, Salo T, Tammi R, Häkkinen H, Jalkanen M, Inki P, Larjava H (1995) Expression of proteoglycans and hyaluronan during wound healing. J Histochem Cytochem 43: 125–135

    Article  CAS  PubMed  Google Scholar 

  17. Shiraishi N, Adachi Y, Kitano S, Bandoh T, Katsuta T, Morimoto A (1999) Indication for and outcome of laparoscopy-assisted Billroth I gastrectomy. Br J Surg 86: 541–544

    Article  CAS  PubMed  Google Scholar 

  18. Suematsu T, Shiromizu A, Yamaguchi K, Shiraishi N, Adachi Y, Kitano S (1999) Convenient murine pneumoperitoneal model for the study of laparoscopic cancer surgery. Surg Laparosc Endosc 9: 279–281

    Article  CAS  Google Scholar 

  19. Volz J, Köster S, Spacek Z, Paweletz N (1999) Characteristic alterations of the peritoneum after carbon dioxide pneumoperitoneum. Surg Endosc 13: 611–614

    Article  CAS  PubMed  Google Scholar 

  20. Volz J, Köster S, Spacek Z, Paweletz N (1999) The influence of pneumoperitoneum used in laparoscopic surgery on an intraabdominal tumor growth. Cancer 86: 770–774

    Article  CAS  PubMed  Google Scholar 

  21. West DC, Hampson IN, Arnold F, Kumar S (1985) Angiogenesis induced by degradation products of hyaluronic acid. Science 228: 1324–1326

    Article  CAS  PubMed  Google Scholar 

  22. Wexner SD, Cohen SM (1995) Port site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 82: 295–298

    Article  CAS  PubMed  Google Scholar 

  23. Whelan RL, Sellers GJ, Allendorf JD, Laird D, Bessler MD, Nowygrod R, Treat MR (1996) Trocar site recurrence is unlikely to result from aerosolization of tumor cells. Dis Colon Rectum 39: S7-S13

    Article  CAS  PubMed  Google Scholar 

  24. Wu JS, Brasfield EB, Guo LW, Ruiz M, Connett JM, Philott GW, Jones DB, Fleshman JW (1997) Implantation of colon cancer at trocar sites is increased by low pressure pneumoperitoneum. Surgery 122: 1–7

    Article  CAS  PubMed  Google Scholar 

  25. Yamaguchi K, Hirabayashi Y, Suematsu T, Shiraishi N, Adachi Y, Kitano S (2000) Hyaluronic acid secretion during carbon dioxide pneumoperitoneum and its association with port-site metastasis in a murine model. Surg Endosc (in press)

Download references

Author information

Authors and Affiliations

  1. Department of Surgery I, Oita Medical University, 1-1 Idaigaoka, Hasama-machi, 879-5593, Oita, Japan

    K. Yamaguchi, Y. Hirabayashi, A. Shiromizu, N. Shirashi, Y. Adachi & S. Kitano

Authors
  1. K. Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y. Hirabayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Shiromizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Shirashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y. Adachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Kitano
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Online publication: 6 February 2001

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yamaguchi, K., Hirabayashi, Y., Shiromizu, A. et al. Enhancement of port site metastasis by hyaluronic acid under CO2 pneumoperitoneum in a murine model. Surg Endosc 15, 504–507 (2001). https://doi.org/10.1007/s004640090016

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004640090016

Key words

Search

Navigation