二氧化碳腹腔镜检查术后的穿刺孔转移。肿瘤细胞的雾化是关键因素吗？
Port-site metastases after CO(2) laparoscopy. Is aerosolization of tumor cells a pivotal factor?
作者信息
Wittich P, Marquet R L, Kazemier G, Bonjer H J
机构信息
Department of Surgery, University Hospital Rotterdam-Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
出版信息
Surg Endosc. 2000 Feb;14(2):189-92. doi: 10.1007/s004649900098.
BACKGROUND
Animal experiments have shown that carbon dioxide (CO(2)) laparoscopy results in more port-site recurrences than gasless laparoscopy. Possible transport of aerosolized tumor cells by CO(2) was investigated in rats.
METHODS
Abdominal cavities of 15 pairs of Wistar Agouti (WAG) rats were connected and 2 x 10(6) or 16 x 10(6) CC 531 cells were injected in the first (donor) rat of each pair. Then 10 l of CO(2) were allowed to flow from the first (donor) to the second (recipient) rat.
RESULTS
No tumor was found in the recipients after injection of 2 x 10(6) cells in the donors. Injection of 16 x 10(6) cells in the donors resulted in very limited tumor growth in the recipients.
CONCLUSIONS
Aerosolization of tumor cells occurs, but the number of intraperitoneal tumor cells required for metastases to occur by this mechanism is extremely high. Therefore, aerosolization of tumor cells appears not to be of major relevance in the pathogenesis of port-site metastases.
背景
动物实验表明，二氧化碳（CO₂）腹腔镜检查比免气腹腹腔镜检查导致更多的穿刺孔复发。在大鼠中研究了CO₂对雾化肿瘤细胞的可能转运作用。
方法
将15对Wistar Agouti（WAG）大鼠的腹腔相连，并向每对中的第一只（供体）大鼠注射2×10⁶或16×10⁶个CC 531细胞。然后让10升CO₂从第一只（供体）大鼠流向第二只（受体）大鼠。
结果
供体大鼠注射2×10⁶个细胞后，受体大鼠未发现肿瘤。供体大鼠注射16×10⁶个细胞后，受体大鼠的肿瘤生长非常有限。
结论
肿瘤细胞会发生雾化，但通过这种机制发生转移所需的腹腔内肿瘤细胞数量极高。因此，肿瘤细胞雾化似乎在穿刺孔转移的发病机制中不具有主要相关性。
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