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首页> 外文期刊>Surgical Endoscopy >Hematogenous spread as a mechanism for the generation of abdominal wound metastases following laparoscopy.
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Hematogenous spread as a mechanism for the generation of abdominal wound metastases following laparoscopy.

机译：血源性扩散是腹腔镜检查后腹部伤口转移发生的一种机制。

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BACKGROUND: We designed this study to determine whether hematogenous spread has a role in the etiology of port site metastases following laparoscopic surgery. METHODS: The study design had two parts. In experiment 1, two groups (n = 30) of male Dark Agouti rats were studied. Under general anesthesia, the first group (20 rats) underwent 15 mins of laparoscopic insufflation, followed by an injection of a suspension of 105 Dark Agouti mammary adenocarcinoma (DAMA) cells into the internal jugular vein and a further 15-mins period of insufflation. The laparoscopic ports were then removed, and the wounds were closed and marked. In the second group (n = 10), the procedure was identical except that a 2.5-cm midline laparotomy was performed 15 mins after the commencement of anesthesia and insufflation was not used. The laparotomy was closed in two layers. In experiment 2, one group (n = 4) was studied. The study protocol was identical to the first laparoscopic group except that a larger number of 106 DAMA cells were injected. All rats in both experiments were killed 15 days later, and the injection site, laparoscopy wounds, and laparotomy wound were examined histologically by a blinded histopathologist. RESULTS: In experiment 1, one port site tumor was detected in the laparoscopic group and no wound metastases were found in the laparotomy group. Postoperative weight loss was significantly less in the laparoscopic group (p < 0.001). In experiment 2, no port site metastases were detected. CONCLUSION: Although hematogenous spread is a possible mechanism in the development of port site metastases, judging from the low number of port site metastases in this study as compared to previous reports using this tumor model, this mechanism is unlikely to be a major contributor to the problem of wound metastasis following laparoscopy.
机译：背景：我们设计了这项研究，以确定在腹腔镜手术后血行扩散是否在端口部位转移的病因中起作用。方法：研究设计分为两个部分。在实验1中，研究了两组（n = 30）雄性Dark Agouti大鼠。在全身麻醉下，第一组（20只大鼠）进行15分钟的腹腔镜注气，然后将105个Dark Agouti乳腺腺癌细胞（DAMA）细胞的悬浮液注入颈内静脉，再注入15分钟。然后移开腹腔镜端口，并闭合伤口并标记。在第二组（n = 10）中，程序相同，只是在麻醉开始后15分钟进行了2.5厘米的中线剖腹手术，并且未使用吹入法。剖腹手术分为两层。在实验2中，研究了一组（n = 4）。该研究方案与第一个腹腔镜组相同，只是注射了106个DAMA细胞。两个实验中的所有大鼠均在15天后被处死，并由盲法病理学家对注射部位，腹腔镜伤口和剖腹手术伤口进行组织学检查。结果：在实验1中，腹腔镜检查组发现1个端口部位肿瘤，而剖腹手术组未发现伤口转移。腹腔镜组的术后体重减轻明显更少（p <0.001）。在实验2中，未检测到端口部位转移。结论：尽管血源性扩散是港口部位转移发生的一种可能机制，但从本研究中港口部位转移的数量与以前使用该肿瘤模型的报道相比来看，这种转移的可能性不大。腹腔镜检查后伤口转移的问题。

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