Risk factors contributing to early occurrence of port site metastases of laparoscopic surgery for malignancy

In this article, the authors present an up-to-date review of our experience and that of the medical literature encompassing all important aspects of p ort site metastases after laparoscopic surgery for malignancy and to search for potential risks with contribution to early occurrence of port site met astases after laparoscopic surgery. We used a Medline computer database sea rch to conduct for pertinent articles through September 1996. Crossreferenc ing identified additional publications. We found that the majority of recur rences were in patients with adenocarcinoma cell type, advanced stage (far- advanced disease), and often with diffuse peritoneal carcinomatosis, sugges ting that port site metastases may contribute to the highly aggressive natu re of the disease. Risk factors that contributed to early occurrence of por t site metastases were ovarian cancers, presence of ascites, and diagnostic or palliative procedures for malignancy (P < 0.0001, P = 0.008, and P < 0. 001, respectively). Practitioners should exercise extreme caution when usin g laparoscopic techniques to manage the care of these patients. (C) 1999 Ac ademic Press.