Irrigation of port sites: prevention of port site metastases?

J Laparoendosc Adv Surg Tech A. 2004 Jun;14(3):125-9. doi: 10.1089/1092642041255423.

Abstract

Introduction: Port site metastases can occur when free viable tumor cells implant at trocar wounds. Irrigation of port sites with cytotoxic agents has been suggested to prevent port site metastases. The objective of this study is to assess whether tumor growth at port sites can be reduced by irrigation of these port sites.

Methods: WAG rats were insufflated with CO(2) for 20 minutes and 5 x 10(5) CC531 tumor cells were injected intraperitoneally. Port sites were irrigated after completion of the pneumoperitoneum with povidone-iodine, a mixture of taurolidine and heparin, or sodium chloride. Controls did not undergo any irrigation of port sites. In experiment 1, all 16 rats had all 4 irrigation modalities. In experiment 2, four groups of 20 rats had one type of irrigation on two trocar wounds. Tumor growth was evaluated 4 weeks after the procedure.

Results: No difference in tumor growth at trocar wounds was found between any type of irrigation and controls in both experiments.

Conclusion: In this experimental model, no beneficial or adverse effects of irrigation of port sites could be shown.

MeSH terms

  • Adenocarcinoma / pathology
  • Animals
  • Heparin / administration & dosage
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Male
  • Neoplasm Seeding*
  • Neoplasm Transplantation
  • Pneumoperitoneum, Artificial / adverse effects
  • Pneumoperitoneum, Artificial / methods*
  • Povidone-Iodine / administration & dosage
  • Punctures / adverse effects*
  • Rats
  • Rats, Inbred Strains
  • Sodium Chloride / administration & dosage
  • Taurine / administration & dosage
  • Taurine / analogs & derivatives*
  • Therapeutic Irrigation*
  • Thiadiazines / administration & dosage

Substances

  • Thiadiazines
  • Taurine
  • Sodium Chloride
  • Povidone-Iodine
  • taurolidine
  • Heparin