Neuhaus S J, Watson D I, Ellis T, Rowland R, Rofe A M, Pike G K, Mathew G, Jamieson G G
Royal Adelaide Centre for Endoscopic Surgery, Royal Adelaide Hospital, Australia.
Surgery. 1998 May;123(5):579-83. doi: 10.1067/msy.1998.88089.
There is growing evidence that laparoscopy for malignancy is associated with an increased incidence of metastasis to port sites. This study investigated the effect of different insufflation gases on port-site metastasis after laparoscopy in an established animal model.
Forty-eight Dark Agouti rats with an established adenocarcinoma in the left flank underwent laparoscopic intraperitoneal tumor laceration. The gas used for insufflation was one of the following (12 rats in each group): (1) CO2, (2) N2O, (3) helium, or (4) air. Rats were killed 7 days after the procedure, and the port sites were examined for the presence of tumor metastasis.
Tumor involvement of port sites was significantly less likely after helium insufflation than in the other groups (p < 0.0001). There was no significant difference between the air, CO2, and N2O groups.
This study suggests that the development of metastases in port sites after laparoscopy may be influenced in part by the choice of insufflation gas used to create the pneumoperitoneum. In particular, helium was associated with a reduced rate of metastases.
越来越多的证据表明，腹腔镜恶性肿瘤手术与端口部位转移发生率增加有关。本研究在已建立的动物模型中，调查了不同充气气体对腹腔镜术后端口部位转移的影响。
48只左侧胁腹患有既定腺癌的黑豚鼠接受了腹腔镜下腹腔内肿瘤撕裂术。用于充气的气体为以下之一（每组12只大鼠）：（1）二氧化碳，（2）氧化亚氮，（3）氦气，或（4）空气。术后7天处死大鼠，检查端口部位是否存在肿瘤转移。
与其他组相比，氦气充气后端口部位的肿瘤累及可能性显著降低（p<0.0001）。空气、二氧化碳和氧化亚氮组之间无显著差异。
本研究表明，腹腔镜术后端口部位转移的发生可能部分受到用于建立气腹的充气气体选择的影响。特别是，氦气与转移率降低有关。
