Neuhaus S J, Ellis T, Jamieson G G, Watson D I
The Royal Adelaide Centre for Endoscopic Surgery, University Department of Surgery, Royal Adelaide Hospital, South Australia, Australia.
Br J Surg. 1999 Mar;86(3):400-4. doi: 10.1046/j.1365-2168.1999.01031.x.
Conclusions drawn from clinical reports of port site metastases following laparoscopic resection of intra-abdominal malignancy are now supported by a burgeoning experimental literature which suggests that laparoscopy promotes tumour metastasis to wounds. This study investigated the effect of intraperitoneal blood and heparin on the incidence of tumour cell implantation and port site metastasis.
Twenty-four Dark Agouti rats underwent laparoscopy with carbon dioxide insufflation and the instillation of a tumour cell suspension and/or blood into the peritoneal cavity. Rats were allocated randomly to one of the following study groups (six rats per group): (1) controls; (2) intraperitoneal blood (2 ml blood introduced from a syngeneic donor rat); (3) intraperitoneal heparin; (4) intraperitoneal blood and heparin. Rats were killed 7 days after the procedure, and the peritoneal cavity and port sites were examined for the presence of tumour.
Tumour implantation and port site metastases were reduced by the intraperitoneal administration of heparin, but increased by the presence of intraperitoneal blood.
The results of this study suggest that tumour implantation following laparoscopy is promoted by the presence of intraperitoneal blood and that this effect may be reduced by the use of intraperitoneal heparin.
腹腔镜切除腹腔内恶性肿瘤后关于端口部位转移的临床报告所得出的结论，如今得到了大量实验文献的支持，这些文献表明腹腔镜检查会促使肿瘤转移至创口处。本研究调查了腹腔内血液和肝素对肿瘤细胞植入及端口部位转移发生率的影响。
24只黑豚鼠接受了二氧化碳气腹腹腔镜检查，并向腹腔内注入肿瘤细胞悬液和/或血液。将大鼠随机分配至以下研究组之一（每组6只大鼠）：（1）对照组；（2）腹腔内血液组（从同基因供体大鼠引入2毫升血液）；（3）腹腔内肝素组；（4）腹腔内血液和肝素组。术后7天处死大鼠，检查腹腔和端口部位是否存在肿瘤。
腹腔内给予肝素可减少肿瘤植入和端口部位转移，但腹腔内血液的存在会使其增加。
本研究结果表明，腹腔内血液的存在会促进腹腔镜检查后的肿瘤植入，而使用腹腔内肝素可能会降低这种影响。
