Wu J S, Pfister S M, Ruiz M B, Connett J M, Fleshman J W
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
J Surg Oncol. 1998 Sep;69(1):9-13; discussion 14. doi: 10.1002/(sici)1096-9098(199809)69:1<9::aid-jso3>3.0.co;2-7.
Pneumoperitoneum increases the trocar-site tumor implantation rate using a human colon cancer cell line in a hamster model. The purpose of this study was to determine whether local treatment of trocar sites with potential tumoricidal agents can inhibit tumor implantation after pneumoperitoneum.
GW-39 human colon cancer cells (0.5 ml of 2.5% v/v; 8.0 x 10(5) cells) were injected throughout the abdomen of 133 Golden Syrian hamsters through a midline incision. The animals were randomized to receive either untreated 5-mm trocars in each abdominal quadrant (group I control, n = 49), trocars dipped in 10% povidone-iodine (group II, n = 53), or trocars coated with 1% silver sulfadiazine (group III, n = 51). The midline wounds were also coated with the respective agents before closing. Pneumoperitoneum was then maintained at 10 mmHg for 10 min, after which the trocar wounds were closed. In group II, the trocar sites were treated with a coat of povidone-iodine after the trocars were withdrawn and before closing. Gross and microscopic tumor implants were analyzed at 7 weeks postoperatively.
The rate of tumor cell implantation at trocar sites was reduced from 93% (172/184) in the control group to 75% (126/168) and 78% (141/180) in groups II and III, respectively (P < 0.0001). Fewer palpable tumors were detected in groups II and III (40% and 23%, respectively) than in the control group (72%, P < 0.0001). Mean tumor mass in group III (0.4+/-0.1 g), but not in group II (1.0+/-0.2 g), was significantly less than that in the control group (1.3+/-0.1 g, P < 0.01). Overall tumor involvement of the larger midline wound was similar for all groups (I = 80%, II = 79%, III = 71%). However, palpable tumors were identified more frequently in group I (67%) than in groups II and III (43%, P < 0.05; 22%, P < 0.01, respectively).
Pretreatment of abdominal wounds with povidone-iodine or silver sulfadiazine can reduce tumor implantation after pneumoperitoneum in a hamster model.
在仓鼠模型中，气腹会增加使用人结肠癌细胞系时穿刺部位肿瘤种植率。本研究的目的是确定用具有潜在杀肿瘤作用的药物对穿刺部位进行局部处理是否能抑制气腹后的肿瘤种植。
通过中线切口将GW - 39人结肠癌细胞（0.5 ml的2.5% v/v；8.0×10⁵个细胞）注射到133只金黄叙利亚仓鼠的整个腹腔。动物被随机分为四组，每组在每个腹象限接受未经处理的5毫米套管针（I组对照，n = 49）、浸于10%聚维酮碘中的套管针（II组，n = 53）或涂有1%磺胺嘧啶银的套管针（III组，n = 51）。中线伤口在闭合前也用相应药物涂抹。然后将气腹维持在10 mmHg 10分钟，之后闭合套管针伤口。在II组中，套管针拔出后且闭合前，穿刺部位用一层聚维酮碘处理。术后7周分析大体和显微镜下肿瘤种植情况。
穿刺部位肿瘤细胞种植率从对照组的93%（172/184）分别降至II组的75%（126/168）和III组的78%（141/180）（P < 0.0001）。II组和III组可触及肿瘤的检出率（分别为40%和23%）低于对照组（72%，P < 0.0001）。III组的平均肿瘤质量（0.4±0.1 g）显著低于对照组（1.3±0.1 g，P < 0.01），而II组（平均肿瘤质量1.0±0.2 g）则不然。所有组较大中线伤口的总体肿瘤累及情况相似（I组 = 80%，II组 = 79%，III组 = 71%）。然而，I组可触及肿瘤的检出频率（67%）高于II组（43%，P < 0.05）和III组（22%，P < 0.01）。
在仓鼠模型中，用聚维酮碘或磺胺嘧啶银预处理腹部伤口可降低气腹后的肿瘤种植率。
