Port site recurrences after laparoscopy for malignant disease

Reports of recurrent malignant disease developing at laparoscopic port site s has created considerable controversy among surgeons. Many have implicated the technique of laparoscopy as a cause of metastases and this has led to condemnation of laparoscopy in malignant disease by many surgeons. A review of the case reports, as well as animal studies, reveals the problem to be considerably more complex. Based on experimental models, reported cases, an d our experience at the University of Texas M. D. Anderson Cancer Center, w e have arrived at some substantive conclusions regarding this phenomenon. P ort site recurrences (PSRs) after laparoscopy for malignant disease can occ ur as the only site of recurrence, but this is an extremely rare event, and the incidence does not appear to be significantly different from the devel opment of wound recurrences after open laparotomy for malignancy. It is lik ely that port site recurrences reflect the underlying biology of the malign ant disease, rather than an effect of the technique of laparoscopy. (C) 199 9 Wiley-Liss, Inc.