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首页> 外文期刊>Surgical Endoscopy >Efficacy of surgical measures in preventing port-site recurrences in a porcine model.
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Efficacy of surgical measures in preventing port-site recurrences in a porcine model.

机译：外科手术措施在预防猪模型中港口部位复发的功效。

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BACKGROUND: Port-site recurrences are serious complications of laparoscopy performed for cancer. Incidences reported in the literature vary between 0% and 21%, suggesting an influence of the surgeon. METHODS: The aim of this experimental, prospective, randomized, single-blind study was to investigate the influence that the quality surgery has on the incidence of port-site recurrences. After a 12-mmHg carbon dioxide (CO2) pneumoperitoneum was created, 10(7) human HeLa cell were injected into the peritoneal cavity of 18 pigs, creating a xenogeneic tumor. Laparoscopic sigmoid resections then were performed using four trocars and a transanal double-stapling technique. The following protective measures were applied in nine animals: trocar fixation, prevention of gas leaks, rinsing of instruments with povidone-iodine, minilaparotomy protection, rinsing of trocars before removal, peritoneal closure, and rinsing of all wounds with povidoneiodine. Surgeons and type of procedures were randomized. After 4 weeks, the animals were killed and all portsites excised. Blinded immunohistologic analysis with antihuman pancytokeratin antibody was performed. RESULTS: Tumor recurrence was present in 23 of 36 port sites (63.8%) in the control group, but only in 5 of 36 port sites (13.8%) in the group that received protective measures (p = 0.002; Fisher's exact test). No peritoneal carcinosis nor anastomotic recurrences were observed. CONCLUSION: These results strongly suggest that the quality of surgical technique has an influence on the incidence of port-site recurrences. From now on, we propose to use these protective measures routinely in cancer laparoscopy.
机译：背景：腹腔镜复发是腹腔镜检查对癌症的严重并发症。文献中报道的发病率在0％和21％之间变化，表明外科医生的影响。方法：这项实验性，前瞻性，随机，单盲研究的目的是研究优质手术对移植部位复发的影响。创建了12mmHg的二氧化碳（CO2）气腹膜后，将10（7）个人HeLa细胞注射到18只猪的腹膜腔中，从而产生了异种肿瘤。然后使用四根套管针和经肛门双吻合技术进行腹腔镜乙状结肠切除术。对9只动物采用了以下保护措施：套管针固定，预防气体泄漏，用聚维酮碘冲洗器械，微型腹腔镜切开术，在移除前冲洗套管针，腹膜封闭以及用聚维酮碘冲洗所有伤口。外科医生和手术类型是随机的。 4周后，将动物处死并切除所有portites。用抗人全细胞角蛋白抗体进行了盲法免疫组织学分析。结果：对照组中36个港口部位中的23个（63.8％）存在肿瘤复发，但是在采取保护措施的组中36个港口部位中的5个（13.8％）存在肿瘤复发（p = 0.002; Fisher精确检验）。没有观察到腹膜癌变和吻合口复发。结论：这些结果有力地表明手术技术的质量对港口部位复发的发生率有影响。从现在开始，我们建议在癌症腹腔镜检查中常规使用这些保护措施。

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