Canis M, Botchorishvili R, Wattiez A, Mage G, Pouly J L, Bruhat M A
Department of Obstetrics, Gynecology and Reproductive Medicine, Polyclinique de l'Hotel Dieu, Clermont-Ferrand, France.
Obstet Gynecol. 1998 Jul;92(1):104-8. doi: 10.1016/s0029-7844(98)00145-8.
To compare tumor growth, intraperitoneal implantation, and abdominal wall metastasis after laparotomy and CO2 pneumoperitoneum in a rat ovarian cancer model.
To mimic intraoperative rupture of an ovarian tumor in a syngenic rat ovarian carcinoma model, 10(5) malignant cells were injected intraperitoneally after a 5-cm vertical midline laparotomy or after the insufflation of a CO2 pneumoperitoneum achieved with 4 mmHg or 10 mmHg intra-abdominal pressure. Two weeks later, the intraperitoneal tumor growth and the tumor dissemination were evaluated semiquantitatively with a scoring system. The scores attributed to each organ were added to calculate the dissemination score of each animal.
The mean (+/-SD) dissemination score was 83.4+/-12 in the laparotomy group and 67.3+/-16 and 71.9+/-17 in the 4 and 10 mmHg CO2 pneumoperitoneum groups, respectively (P < .01). The scores for the peritoneum were 21.8+/-3.8 in the 10 mmHg pneumoperitoneum group and 18+/-2.4 in the laparotomy group (P < .01). In the laparotomy group, the implant found along the midline scar accounted for a mean of 62.6+/-15% of the peritoneal score, whereas the trocar site metastases did not influence the peritoneal score in the pneumoperitoneum groups. The incidence of wound metastasis was 96% in the laparotomy group and 55% and 54% in the 4 mmHg and 10 mmHg pneumoperitoneum groups, respectively.
In this model, tumor growth was greater after laparotomy than after laparoscopy, but peritoneal tumor dissemination was more severe after CO2 pneumoperitoneum.
在大鼠卵巢癌模型中比较剖腹手术和二氧化碳气腹术后的肿瘤生长、腹腔内种植及腹壁转移情况。
在同基因大鼠卵巢癌模型中模拟卵巢肿瘤术中破裂，于5cm垂直中线剖腹手术后或在腹腔内压力为4mmHg或10mmHg建立二氧化碳气腹后，经腹腔注射10(5)个恶性细胞。两周后，采用评分系统对腹腔内肿瘤生长和肿瘤播散进行半定量评估。将赋予每个器官的分数相加，计算每只动物的播散分数。
剖腹手术组的平均（±标准差）播散分数为83.4±12，4mmHg和10mmHg二氧化碳气腹组分别为67.3±16和71.9±17（P<.01）。10mmHg气腹组腹膜的分数为21.8±3.8，剖腹手术组为18±2.4（P<.01）。在剖腹手术组中，沿中线瘢痕发现的种植灶平均占腹膜分数的62.6±15%，而套管针穿刺部位转移对气腹组的腹膜分数无影响。剖腹手术组伤口转移发生率为96%，4mmHg和10mmHg气腹组分别为55%和54%。
在该模型中，剖腹手术后肿瘤生长大于腹腔镜检查后，但二氧化碳气腹后腹膜肿瘤播散更严重。
