Laparoscopic port site recurrences in oncologic surgery--a review

The aim of this paper was to review the world's literature regarding port site recurrences. A Medline search was performed for all port site recurrences published in the literature. These reports were analysed and port site recurrences studied to determine initial stage of cancers, time to recurrence and whether the port site was an isolated site of recurrence or part of widespread intra-abdominal disease. The possible aetiologies were similarly reviewed and several recent basic science reports assessed. To date, 93 port site recurrences have been published. These have occurred with colorectal cancers as well as ovarian, gastric, pancreatic and other malignancies. Often, these recurrences are isolated and most standard means of prevention of cell dissemination may not prevent their occurrence. Possible mechanisms include aerosolisation of tumour cells, exfoliation, and changes in immune function. Port site recurrences continue to be reported. Their aetiology is unclear but the occurrence is of concern and requires continued scrutiny for laparoscopic oncologic surgery.