Influence of cytotoxic agents on intraperitoneal tumor implantation after laparoscopy

(URPOSE)-U-P: Recent experimental studies suggest that laparoscopic surgery for abdominal malignancy may be associated with increased tumor implantati on. This study investigated the influence of cytotoxic agents (administered intraperitoneally or intramuscularly) on implantation of a tumor cell susp ension after laparoscopic surgery in an experimental model. METHODS: Thirty -three Dark Agouti rats underwent laparoscopy with CO, insufflation and ins tillation of a tumor cell suspension into the abdominal cavity. Rats were r andomly allocated to one of the following study groups (9 rats in the contr ol group, 6 rats in all other groups): 1) control (no intraperitoneal insti llation); 2) intraperitoneal normal saline (0.9 percent); 3) intraperitonea l povidone-iodine (Betadine(R) to normal saline 1:10 dilution); 4) intraper itoneal methotrexate (2 doses of 0.125 mg/kg body weight in normal saline a dministered 24 hours apart); 5) intramuscular injection of 2 doses of 0.125 mg/kg body weight administered 24 hours apart (no intraperitoneal agent). Rats were killed 7 days after the procedure, and the peritoneal cavity and port sites were examined for the presence of tumor. RESULTS: A significant reduction in tumor implantation and port-site metastases was observed in al l treatment groups (povidone-iodine and intramuscular and intraperitoneal m ethotrexate). CONCLUSIONS: This study suggests that tumor implantation afte r laparoscopic surgery and pea-site metastases might be prevented by the in traperitoneal or systemic administration of cytotoxic agents. Further studi es are needed to determine whether these findings can be applied to clinica l practice.