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Tumor seeding following laparoscopy: international survey
V Paolucci1, B Schaeff, M Schneider
1Klinikum der Johann Wolfgang Goethe Universität, Zentrum der Chirurgie, Klinik für Allgemeinchirurgie, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany.
World Journal of Surgery
|October 8, 1999
Summary
Laparoscopic surgery for cancer carries a risk of tumor seeding, with port-site recurrences observed in 17.1% of gallbladder cancer cases and 4.6% of colorectal cancer cases. This risk appears higher than with open surgery.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Cancer Research
Background:
- Laparoscopic surgery is increasingly used for intraabdominal tumors across various surgical specialties.
- Tumor seeding is a potential complication of laparoscopic procedures for malignancy.
Purpose of the Study:
- To investigate the incidence and characteristics of tumor seeding following laparoscopic surgery for cancer.
- To determine if tumor seeding is a rare event or a typical complication.
Main Methods:
- A questionnaire survey was distributed to 1052 surgical department chairmen and members of surgical societies in Germany, Switzerland, and Austria.
- Data collected included reported cases of tumor recurrence after laparoscopy for known or apparent malignancies.
Main Results:
- 109 patients developed tumor recurrence after laparoscopic surgery.
- Port-site recurrence was noted in 17.1% of 409 patients with incidental gallbladder carcinoma and 3.9% of 412 patients with colorectal carcinoma.
- Abdominal wall metastasis probability is higher after laparoscopy for cancer compared to open surgery, even with intact specimens and retrieval bags.
Conclusions:
- Laparoscopic surgery for cancer presents a specific risk for intraperitoneal tumor cell seeding and implantation.
- Preventive measures like intact specimens and retrieval bags do not eliminate the risk of port-site recurrences.
- Early peritoneal carcinosis suggests a distinct laparoscopic risk for tumor cell dissemination.