Abdominal incision tumor implantation following pneumoperitoneum laparoscopic procedure vs. standard open incision in a syngeneic rat model.

Abstract

A recent hamster model study suggests that the abdominal wall wound implantation rate increases following laparoscopic colon cancer surgery compared with the traditional open technique. However, results of that study were confounded by several factors, including a midline incision in the laparoscopy group, an unclear definition of wound implantation, significant age variations in study subjects, and cell line use with low viability. The aim of this study was to compare the abdominal incision implantation rates following a pneumoperitoneum-laparoscopic-type procedure with a standard open incision using a syngeneic host/colon cancer rat model. Viable DHD/K12 rat colon carcinoma cells (2 x 10(5) cells/rat) were injected intraperitoneally via 18G angiocath into anesthetized, immunocompetent BD-IX rats (syngeneic host rats). Rats were then randomly divided into open incision and laparoscopy groups. At three weeks post-operatively, tumor growth at the injection, incision, and port sites was measured. Following standard midline incision, 50 percent of rats (26/50 rats) developed wound implantations, whereas only 25 percent of rats (14/57 rats) developed at least one trocar site wound implantation after laparoscopy with pneumoperitoneum. Fourteen percent of trocar sites (16/114 port sites) developed wound implantations. No tumor growth was noted on the peritoneal surfaces other than in the incisional sites. Laparoscopic-type procedure with pneumoperitoneum did not increase wound implantation in a syngeneic host/colon carcinoma rat model compared with the standard open incision technique.