INTRAPERITONEAL INSTILLATION OF TAUROLIDI NE AND HEPARIN FOR THE PREVENTION OF INTRAPERITONEAL TUMOR-GROWTH AND TROCAR METASTASES IN LAPAROSCOPIC SURGERY IN A RAT MODEL

Background: Although port-sire metastases occur after laparoscopic sur gery, there is no generally accepted approach to prevent tumor implant ation so far. Methods: In order to prevent tumor metastases, the effec t of taurolidine and heparin on the growth of colon adenocarcinoma DHD /K12/TRb was measured in vitro and in a rat model. After incubation of the cells with heparin. taurolidine or both substances, the cell kine tics were determined. In a second experiment, tumor cells were adminis tered intraperitoneally in rats (n = 60) and pneumoperitoneum was esta blished over 30 min. Rats were randomized into four groups (I: tumor c ells; II: cells + heparin; III: cells + taurolidine; IV: cells + tauro lidine + heparin). Results: While tumor cell growth was not influenced by heparin in vitro, growth decreased significantly after incubation with taurolidine and taurolidine/heparin, In vivo, intraperitoneal tum or weight was lower in rats receiving heparin (298 +/- 155 mg) and tau rolidine (149 +/- 247 mg than in the control group (596 +/- 278 mg), W hen the two substances were combined, turner growth was even less (21. 5 +/- 36 mg). Trocar metastases were only lower in rats receiving taur olidine or the combination of taurolidine and heparin. Conclusion: In vivo, heparin inhibits intraperitoneal tumor growth only slightly, whi le taurolidine causes a significant decrease in tumor cell growth in v itro as well as intraperitoneal tumor growth and trocar metastases in vivo.