CO_2气腹对人肿瘤细胞腹腔镜戳口种植的影响

Tumor Cell Port Site Implantation in Laparoscopic Surgery Using Carbon Dioxide Pneumoperitoneum.

目的：研究ＣＯ２气腹对人肿瘤细胞腔戳口种植的影响。材料与方法：选用人胃癌细胞株ＳＧＣ－７９０１，注射器注入雄性ＳＤ大鼠腹腔内，气腹机分别产生腹腔静止性气腹和持续性气腹，通过５ｍｍ腹腔穿刺管收集气体至２瓶中，在３７℃５％ＣＯ２环境中培养７天后，显微镜下涂片鉴定是否有肿瘤细胞生长，另取腹腔中冲洗液作一对照结果：静止性气测试组中，未发现有肿瘤细胞生长，而在持续性气腹测试组中。

To investigate the mechanism of tumor cell port site implantation in laparoscopic surgery using CO2 pneumoperitoneum. Methods: Male Spraque-Dawley rats were given gastric cancer cells(cell line SGC-7901) intraperitoneally with a definite concentration. Static or continuous CO2 pneumo was used in 2 separate groups. Each group was subdivided into subgroups with various gas flow rate, pneumo pressure and the duration of procedure. Air samples were collected by means of a 5mm trocar and were submitted for in-cubation at 37℃with 5% CO2 for one week, the cultures were then examined for the presence of the tumor cells under microscopy. Samples of peritoneal washing cultured under similar conditions served as positive controls. Results: After one week of incubation, 3 of 4 culture samples in the continuous CO2 pneumo group with high gas flow(5L/min) at pneumo pressure of 30mmHg for 60 min demonstrated tumor cells growth, and all 4 peritoneal washing samples showed positive. However, other samples showed negative. Con-clusions: The potential of tumor cell implantation in the port site during laparoscopy was shown in this ex-periment to be related to the rate of gas flow, the pneumo pressure and the duration of surgical procedure.