Reduction of peritoneal trauma by using nonsurgical gauze leads to less implantation metastasis of spilled tumor cells
Reduction of peritoneal trauma by using nonsurgical gauze leads to less implantation metastasis of spilled tumor cells
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DOI：
10.1097/00000658-199802000-00014
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发表时间：
1998-02-01
影响因子：
9
通讯作者：
Jeekel, H
中科院分区：
文献类型：
--
作者：
van den Tol, RM;van Rossen, EME;Jeekel, H
目的探讨腹膜损伤是否促进肿瘤细胞在损伤腹膜表面的粘附，腹膜损伤是否促进腹膜外肿瘤的生长;并评估创伤的量是否与肿瘤细胞粘附的程度以及局部和远处肿瘤生长相关。背景数据在结肠直肠癌的潜在治愈性切除术后，最常见的复发部位是局部区域。我们以前证明，手术创伤诱导一系列事件，导致粘连形成。同样的机制可能是负责改善肿瘤细胞的粘附和生长促进早期局部recursion.MethodsA可重复的大鼠模型中，腹膜损伤造成标准化摩擦的腹膜与不同质地的手术纱布。在第一个实验中，在围手术期腹腔内注射CC-531肿瘤细胞后3周，半定量评估创伤和非创伤腹膜部位的肿瘤细胞粘附和生长。在第二个实验中，研究了腹膜创伤对异位肿瘤生长的影响（CC-531植入肾包膜下）。在最后的实验中，我们评估了腹膜创伤后肿瘤细胞粘附和生长促进因子是积极的，他们是否可以被动转移到幼稚nontraumatized腹腔cavities.ResultsA显着相关性腹膜创伤的量和肿瘤的程度，采取在损坏的腹膜表面被发现（p小于或等于0.018）。在腹膜严重创伤后，未直接创伤的远端腹膜部位的肿瘤发生率也显著高于中度创伤后（p小于或等于0.005）。此外，观察到腹膜创伤程度与肾包膜下异位肿瘤生长之间存在显著相关性（p ≤ 0.009）。最后的实验表明，在几个小时内造成腹膜创伤后，肿瘤生长促进作用可以被动地转移到幼稚recipients.ConclusionsSurgical创伤是一个重要的因素，在促进局部复发。创伤的强化效应并不局限于受伤部位，而是具有普遍性。因此，应使用温和的技术和材料避免不必要的手术创伤。
ObjectivesTo evaluate whether infliction of peritoneal trauma would promote tumor cell adherence to damaged peritoneal surfaces; to investigate whether peritoneal damage could promote tumor growth of extraperitoneal tumors; and to evaluate whether the amount of trauma correlated with the degree of tumor cell adherence and local and distant tumor growth.Background DataAfter potentially curative resection of colorectal carcinoma, the most common site for recurrence is locoregional. We previously demonstrated that surgical trauma induces a cascade of events leading to adhesion formation. The same mechanisms may be responsible for improved tumor cell adherence and growth facilitation in early local recurrence.MethodsA reproducible rat model was used in which peritoneal damage was inflicted by standardized rubbing of the peritoneum with surgical gauzes of different texture. In the first experiment, tumor cell adherence and growth at traumatized and nontraumatized peritoneal sites were assessed semiquantitatively 3 weeks after perioperative intra-abdominal injection of CC-531 tumor cells. In the second experiment, the effect of peritoneal trauma on ectopic tumor growth was investigated (CC-531 implanted under the renal capsule). In the final experiment, we evaluated how soon after peritoneal traumatization tumor cell adhesion and growth-promoting factors were active and whether they could be passively transferred to naive nontraumatized abdominal cavities.ResultsA significant correlation between the amount of peritoneal trauma and the degree of tumor take at damaged peritoneal surfaces was found (p less than or equal to 0.018). Tumor take at remote peritoneal sites not directly traumatized was also significantly higher after severe trauma than after moderate trauma of the peritoneum (p less than or equal to 0.005). In addition, a significant correlation between the degree of peritoneal trauma and the growth of ectopic tumors under the renal capsule was observed (p less than or equal to 0.009). The final experiment demonstrated that within a few hours after infliction of peritoneal trauma, tumor growth-promoting effects could be passively transferred to naive recipients.ConclusionsSurgical trauma is an important factor in the promotion of local recurrence. The enhancing effect of trauma is not restricted to the inflicted site but rather has a generalized character. Avoidance of unnecessary surgical trauma by using gentle techniques and materials is therefore indicated.