The effect of pneumoperitoneum on dissemination and scar implantation of intra-abdominal tumor cells

Purpose: The role of laparoscopy for the treatment of cancer remains contro versial, and a particular concern is port site metastases after laparoscopi c surgery. Since laparoscopy is being performed with increasing frequency, the question arises as to whether it is a safe oncological procedure. After intraperitoneal inoculation of renal cell carcinoma cells in a mouse model , we compare abdominal wall scar implantation following laparoscopic trocar insertion and pneumoperitoneum with standard laparotomy, and examine the e ffects on tumor dissemination in the peritoneal cavity. Materials and Methods: Following intra-abdominal RENCA cell inoculation, Ba lb/c mice were randomized into group 1-20 mice that underwent carbon dioxid e pneumoperitoneum and telescope trocar insertion, group 2-20 subjected to laparotomy and group 3-10 anesthetized only. All animals were sacrificed 2 weeks after inoculation, and abdominal wall metastases and intraperitoneal tumor distribution were evaluated. Results: Overall, intra-abdominal implantation of inoculated RENCA tumor ce lls was detected in 15 of 20 animals (75%) in group 1, 14 of 20 (70%) in gr oup 2 and 10 of 10 (100%) in group 3. Wound metastases developed in 46.7% o f the mice in group 1 and 50% in group 2. Conclusions: There was no difference among the groups in the pattern of int raperitoneal tumor implants and scar seeding incidence. Pneumoperitoneum do es not facilitate port site metastases.