不同气体以及腹腔内注入抗黏附剂或细胞毒性剂对大鼠模型腹腔镜手术中腹膜肿瘤细胞生长和种植的影响。

Influence of different gases and intraperitoneal instillation of antiadherent or cytotoxic agents on peritoneal tumor cell growth and implantation with laparoscopic surgery in a rat model.

作者信息

Jacobi C A, Wildbrett P, Volk T, Müller J M

机构信息

Department of Surgery, Humboldt-University of Berlin, Schumannstrasse 20/21, 10098 Berlin, Germany.

出版信息

Surg Endosc. 1999 Oct;13(10):1021-5. doi: 10.1007/s004649901160.

DOI:10.1007/s004649901160

PMID:10526040

Abstract

BACKGROUND

A generally accepted approach to prevent tumor implantation with laparoscopic surgery does not exist. Alternative gases in combination with intraperitoneal instillation of different antiadherent or cytotoxic agents have not been evaluated.

METHODS

The effect of taurolidine, heparin, and povidone-iodine on the growth of colon adenocarcinoma DHD/K12/TRb was measured in rats undergoing laparoscopy with carbon dioxide (n = 40), helium (n = 40), or xenon (n = 40). In the procedure, 10(4) tumor cells were administered intraperitoneally, and pneumoperitoneum was established over 30 min at 8 mmHg with the different gases. The rats additionally received intraperitoneal instillation with one of the following: 1 ml of Ringer's solution, 1 ml of 0.5% taurolidine, 1 ml 0.5% taurolidine with heparin (10 U/ml), or 1 ml 0.25% of povidone-iodine. Tumor growth was measured after 4 weeks.

RESULTS

Median intraperitoneal tumor weight was lower in rats receiving taurolidine (CO(2): 10 mg; helium: 50 mg; xenon: 39.5 mg) or taurolidine with heparin (CO(2): 4 mg; helium: 4.5 mg; xenon: 46.5 mg) in all gas groups than in the control groups (CO(2): 427 mg; helium: 268 mg; xenon: 345 mg) (p < 0.001). Whereas povidone-iodine caused significantly lower tumor growth in the CO(2) group (56.5 mg) (p < 0.01), the combination of helium (145 mg) and xenon (457 mg) with povidone-iodine produced no reduction of tumor growth as compared with the control groups (helium: 268 mg; xenon: 345 mg).

CONCLUSIONS

Taurolidine and taurolidine with heparin significantly inhibit intraperitoneal tumor growth, with different gases used for pneumoperitoneum. Only povidone-iodine caused significant decrease of tumor growth in combination with CO(2). The combination of xenon and povidone-iodine should not be used in patients with cancer because of increased tumor growth.

摘要

背景

目前不存在一种普遍接受的用于预防腹腔镜手术中肿瘤种植的方法。尚未评估替代气体与腹腔内注入不同抗粘连或细胞毒性药物联合使用的效果。

方法

在接受二氧化碳（n = 40）、氦气（n = 40）或氙气（n = 40）腹腔镜手术的大鼠中，测量牛磺罗定、肝素和聚维酮碘对结肠腺癌DHD/K12/TRb生长的影响。在该过程中，经腹腔给予10⁴个肿瘤细胞，并使用不同气体在8 mmHg下30分钟内建立气腹。大鼠还额外接受以下一种物质的腹腔内注入：1 ml林格氏液、1 ml 0.5%牛磺罗定、1 ml含肝素（10 U/ml）的0.5%牛磺罗定或1 ml 0.25%聚维酮碘。4周后测量肿瘤生长情况。

结果

在所有气体组中，接受牛磺罗定（二氧化碳：10 mg；氦气：50 mg；氙气：39.5 mg）或含肝素的牛磺罗定（二氧化碳：4 mg；氦气：4.5 mg；氙气：46.5 mg）的大鼠腹腔内肿瘤重量中位数低于对照组（二氧化碳：427 mg；氦气：268 mg；氙气：345 mg）（p < 0.001）。虽然聚维酮碘在二氧化碳组中导致肿瘤生长显著降低（56.5 mg）（p < 0.01），但与对照组（氦气：268 mg；氙气：345 mg）相比，氦气（145 mg）和氙气（457 mg）与聚维酮碘联合使用并未使肿瘤生长减少。