Experimental assessment of the risk of tumor recurrence after laparoscopic surgery

Experimental assessment of the risk of tumor recurrence after laparoscopic surgery

Background: The aim of this experimental study was to evaluate the risk of tumor recurrence after laparoscopic cecal resection (LCR) of colonic carcinoma in the rat. Methods: The experimental cancer consisted of one million cells (DHK/K12), incorporated in an extracellular matrix, placed and secured...

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Bibliographic Details
Published in:Surgery Vol. 123; no. 4; pp. 427 - 431
Main Authors: Le Moine, Marie-Christine, Navarro, Francis, Burgel, Jean-Stéphane, Pellegrin, André, Khiari, Abdel Raouf, Pourquier, Didier, Fabre, Jean-Michel, Domergue, Jacques
Format: Journal Article
Language:English
Published: New York, NY Mosby, Inc 01-04-1998
Elsevier
Subjects:
Animals
Biological and medical sciences
Colonic Neoplasms - pathology
Colonic Neoplasms - surgery
Gastroenterology. Liver. Pancreas. Abdomen
Laparoscopy - methods
Male
Medical sciences
Neoplasm Staging
Random Allocation
Rats
Rats, Inbred Strains
Recurrence
Risk Assessment
Risk Factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Time Factors
Tumors
Endoscopic surgery
Animal model
Relapse
Carcinoma
Rat
Cecum
Estimation
Rodentia
Risk
Surgical resection
Laparoscopy
Malignant tumor
Colonic disease
Experimental disease
Vertebrata
Mammalia
Treatment
Animal
Digestive diseases
Complication
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Summary:Background: The aim of this experimental study was to evaluate the risk of tumor recurrence after laparoscopic cecal resection (LCR) of colonic carcinoma in the rat. Methods: The experimental cancer consisted of one million cells (DHK/K12), incorporated in an extracellular matrix, placed and secured to the cecal serosa in 110 BD9 rats. Four weeks later, all animals were reoperated through a laparotomy to control tumor growth, and animals with diffuse carcinomatosis were excluded. Eligible animals were randomized either to laparoscopic cecal resection (group LCR, n = 10), to open resection (group OCR, n = 13), or to a control group without resection (group C, n = 13). Resection was always considered as macrocopically complete. All animals were killed 4 weeks after the resection to determine the tumor recurrence and quantify carcinomatosis. Results: We noted diffuse carcinomatosis in 70% of rats in groups C and LCR versus 23% in group OCR ( p = 0.038). For tumors noted as S- (not extending outside the serosa), diffuse carcinomatosis was observed in all animals of group C (3 of 3), in 6 of 8 in group LCR, and 0 of 6 in group OCR ( p = 0.004). The rate of port site or incisional metastases was not significantly different between groups. Conclusions: These preliminary results demonstrated the deleterious impact of the laparoscopy for resection of large bowel malignancy. LCR increased significantly the incidence of a diffuse carcinomatosis even when performed for locally noninvasive tumors (S-). (Surgery 1998;123:427-31.)
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content type line 23
ISSN:0039-6060
1532-7361
DOI:10.1016/S0039-6060(98)70164-3