腹腔镜CO_2气腹对肿瘤生长与种植转移的影响及预防
摘要
CO_2气腹促进肿瘤生长与种植转移的现象近来受到广泛关注，但其机制未能阐明，预防办法尚在探索。本文综述了近几年研究进展，推测改善腹腔酸性环境，纠正细胞酸中毒，可能是抑制CO_2促进肿瘤细胞扩散的重要途径。
The increased occurrence CO2-pneumoperitoneum can promote peritoneal tumor growth and abdominal metastases after laparoscopic surgery for malignant tumors has been widely noticed in recent years, the mechanism is still unknown and the accepted approach to prevent it is under exploring. The aim of this study is to summarize current research and suggest that improving the acid environment of abdominal and mediating cytosonic acidification from peritoneal
macrophages may be a important approach to inhibit peritoneal tumor growth and abdominal metastases in laparoscopic surgery.
The increased occurrence CO2-pneumoperitoneum can promote peritoneal tumor growth and abdominal metastases after laparoscopic surgery for malignant tumors has been widely noticed in recent years, the mechanism is still unknown and the accepted approach to prevent it is under exploring. The aim of this study is to summarize current research and suggest that improving the acid environment of abdominal and mediating cytosonic acidification from peritoneal
macrophages may be a important approach to inhibit peritoneal tumor growth and abdominal metastases in laparoscopic surgery.
引文
1、Bouvy N D,Marquet R L,Jeekel H,et al. Impact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdominal wall metastases. Ann-Surg, 1996,224: 694-700
2、Gutt C N,Riemer V, Kim Z G,et al. Impact of laparoscopic colonic resection on tumour growth and spread in an experimental model.Br-J-Surg, 1999, 86:1180-4
3、Neuhaus S J,Watson D I, Ellis T, et al. Wound metastasis after laparoscopy with different insuffiation gases. Surgery, 1998, 123:579-83
4、Jacobi C A,Sabat R, Bohm B,et al.Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells. Surgery, 1997,121:72-8
5、Mathew, G, Watson D I, Ellis T, et al. The effect of laparoscopy on the movement of tumor cells and metastasis to surgical wounds. Surg-Endosc,1997, 11: 1163-6
6、Watson D I, Mathew G, EllisT, et al..Gasless laparoscopy may reduce the risk of port-site metastases following laparascopic tumor surgery.Arch-Surg, 1997, 132:166-8
7、王秋生，王昭法．非气腹腹腔镜外科的发展现状，中国实用外科杂志，
1999，19：318-319
8、Menes T, Spivak H. Laparoscopy: searching for the proper insufflation gas. Surg-Endosc, 2000,14: 1050-6。
9、王灏、郑民华等．CO_2气腹对人肿瘤细胞腹腔镜戳口种植的影响．外科理论与实践，1999，4：141-143
10、Kohlberger P D, Edwards L, Collins C,et al. Laparoscopic port-site recurrence following surgery for a stage IB squamous cell carcinoma of the cervix with negative lymph nodes. Gynecol-Oncol, 2000, 79:324-6
11、Ikramuddin S, Lucus J, Ellison E C,et al. Detection of aerosolized cells during carbon dioxide laparoscopy..J-Gastrointest-Surg, 1998,2:580-3
12、Volz J,Koster S, Spacek Z,et al..Characteristic alterations of the peritoneum after carbon dioxide pneumoperitoneum .Surg-Endosc,1999,13: 611-4
13、Volz,J,Koster S, Schaeff B,et al. the effects of insufflation gas on tumor-induced lethality in nude mice .Am-J-Obstet-Gynecol, 1998,178:793-5
14、Volz J,Koster S, Spacek Z,et al..The influence ofpneumoperitoneum used in laparoscopic surgery on an intraabdominal tumor growth.Cancer, 1999, 86:770-4
15、Yamaguchi K, Hirabayashi Y, Shiromizu A,et al. Enhancement of port site metastasis by hyaluronic acid under CO2 pneumoperitoneum in a murine model. Surg-Endosc, 2001,15:504-7
16、Kuntz C, Wunsch A, Bodeker C,et al. Effect of pressure and gas type on intraabdominal, subcutaneous, and blood pH in laparoscopy.Surg-Endosc, 2000, 14:367-71
17、Neuhaus S J, Watson D I, Ellis T, et al. The effect of immune enhancement and suppression on the development of laparoscopic port site metastases. Surg-Endosc, 2000,14: 439-43
18、Yoshida T, Kobayashi E,Suminaga Y, et al.Hormone-cytokine response: Pneumoperitoneum vs abdominal wall-lifting in aparoscopic cholecystectomy. Surg Endosc, 1997,11 ;907-910
19、Jacobi C A, Wenger F, Sabat,R,et al. The impact of laparoscopy with carbon dioxide versus helium on immunologic function and tumor growth in a rat model.Dig-Surg, 1998, 15:110-6
20、West M A, Hackam D J, Baker J, et al. Mechanism of decreased in vitro murine macrophage cytokine release after exposure to carbon dioxide. Annals of Surgery, 1997,226:179-190
21、Neuhaus S J, Watson D I, Ellis T, et al. Influence of gases on intraperitoneal immunity during laparoscopy in tumor-bearing rats.World-J-Surg, 2000,24: 1227-31
22、Pidgeon G P, Harmey J H, Kay E,et al. The role of endotoxin/lipopolysaccharide in surgically induced tumour growth in a murine model of metastatic disease. Br-J-Cancer., 1999,81:1311-7
23、Balli J E, Franklin M E, Almeida J A,et al. How to prevent port-site metastases in laparoscopic colorectal surgery..Surg-Endosc,2000,14: 1034-6
24、Neuhaus S J, Ellis T, Jamieson G G,et al..Experimental study of the effect of intraperitoneal heparin on tumour implantation following laparoscopy..Br-J-Surg, 1999,86:400-4
25、Lee S W, Gleason N R, Bessler M,et al. Peritoneal irrigation with povidone-iodine solution after laparoscopic-assisted splenectomy significantly decreases port-tumor recurrence in a murine model.Dis-Colon-Rectum, 1999, 42:319-26
26、Eshraghi N, Swanstrom L L, Bax T, et al. Topical treatments of laparoscopic port sites can decrease the incidence of incision metastasis..Surg-Endosc, 1999,13: 1121-4
27、Jacobi C A, Ordemann J, Bohm B,et al..Inhibition of peritoneal tumor cell growth and implantation in laparoscopic surgery in a rat model. Am J Surg, 1997, 174:359-363
28、Jacobi C A, Peter F J, Wenger F A,et al.New therapeutic strategies to
avoid intra-and extraperitoneal metastases. Dig-Surg, 1999, 16:393-9
29、Volz J, Volz Koster S, Kanis S,et al. Modulation of tumor-induced lethality after pneumoperitoneum in a mouse model..Cancer,2000,89: 262-6
2、Gutt C N,Riemer V, Kim Z G,et al. Impact of laparoscopic colonic resection on tumour growth and spread in an experimental model.Br-J-Surg, 1999, 86:1180-4
3、Neuhaus S J,Watson D I, Ellis T, et al. Wound metastasis after laparoscopy with different insuffiation gases. Surgery, 1998, 123:579-83
4、Jacobi C A,Sabat R, Bohm B,et al.Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells. Surgery, 1997,121:72-8
5、Mathew, G, Watson D I, Ellis T, et al. The effect of laparoscopy on the movement of tumor cells and metastasis to surgical wounds. Surg-Endosc,1997, 11: 1163-6
6、Watson D I, Mathew G, EllisT, et al..Gasless laparoscopy may reduce the risk of port-site metastases following laparascopic tumor surgery.Arch-Surg, 1997, 132:166-8
7、王秋生，王昭法．非气腹腹腔镜外科的发展现状，中国实用外科杂志，
1999，19：318-319
8、Menes T, Spivak H. Laparoscopy: searching for the proper insufflation gas. Surg-Endosc, 2000,14: 1050-6。
9、王灏、郑民华等．CO_2气腹对人肿瘤细胞腹腔镜戳口种植的影响．外科理论与实践，1999，4：141-143
10、Kohlberger P D, Edwards L, Collins C,et al. Laparoscopic port-site recurrence following surgery for a stage IB squamous cell carcinoma of the cervix with negative lymph nodes. Gynecol-Oncol, 2000, 79:324-6
11、Ikramuddin S, Lucus J, Ellison E C,et al. Detection of aerosolized cells during carbon dioxide laparoscopy..J-Gastrointest-Surg, 1998,2:580-3
12、Volz J,Koster S, Spacek Z,et al..Characteristic alterations of the peritoneum after carbon dioxide pneumoperitoneum .Surg-Endosc,1999,13: 611-4
13、Volz,J,Koster S, Schaeff B,et al. the effects of insufflation gas on tumor-induced lethality in nude mice .Am-J-Obstet-Gynecol, 1998,178:793-5
14、Volz J,Koster S, Spacek Z,et al..The influence ofpneumoperitoneum used in laparoscopic surgery on an intraabdominal tumor growth.Cancer, 1999, 86:770-4
15、Yamaguchi K, Hirabayashi Y, Shiromizu A,et al. Enhancement of port site metastasis by hyaluronic acid under CO2 pneumoperitoneum in a murine model. Surg-Endosc, 2001,15:504-7
16、Kuntz C, Wunsch A, Bodeker C,et al. Effect of pressure and gas type on intraabdominal, subcutaneous, and blood pH in laparoscopy.Surg-Endosc, 2000, 14:367-71
17、Neuhaus S J, Watson D I, Ellis T, et al. The effect of immune enhancement and suppression on the development of laparoscopic port site metastases. Surg-Endosc, 2000,14: 439-43
18、Yoshida T, Kobayashi E,Suminaga Y, et al.Hormone-cytokine response: Pneumoperitoneum vs abdominal wall-lifting in aparoscopic cholecystectomy. Surg Endosc, 1997,11 ;907-910
19、Jacobi C A, Wenger F, Sabat,R,et al. The impact of laparoscopy with carbon dioxide versus helium on immunologic function and tumor growth in a rat model.Dig-Surg, 1998, 15:110-6
20、West M A, Hackam D J, Baker J, et al. Mechanism of decreased in vitro murine macrophage cytokine release after exposure to carbon dioxide. Annals of Surgery, 1997,226:179-190
21、Neuhaus S J, Watson D I, Ellis T, et al. Influence of gases on intraperitoneal immunity during laparoscopy in tumor-bearing rats.World-J-Surg, 2000,24: 1227-31
22、Pidgeon G P, Harmey J H, Kay E,et al. The role of endotoxin/lipopolysaccharide in surgically induced tumour growth in a murine model of metastatic disease. Br-J-Cancer., 1999,81:1311-7
23、Balli J E, Franklin M E, Almeida J A,et al. How to prevent port-site metastases in laparoscopic colorectal surgery..Surg-Endosc,2000,14: 1034-6
24、Neuhaus S J, Ellis T, Jamieson G G,et al..Experimental study of the effect of intraperitoneal heparin on tumour implantation following laparoscopy..Br-J-Surg, 1999,86:400-4
25、Lee S W, Gleason N R, Bessler M,et al. Peritoneal irrigation with povidone-iodine solution after laparoscopic-assisted splenectomy significantly decreases port-tumor recurrence in a murine model.Dis-Colon-Rectum, 1999, 42:319-26
26、Eshraghi N, Swanstrom L L, Bax T, et al. Topical treatments of laparoscopic port sites can decrease the incidence of incision metastasis..Surg-Endosc, 1999,13: 1121-4
27、Jacobi C A, Ordemann J, Bohm B,et al..Inhibition of peritoneal tumor cell growth and implantation in laparoscopic surgery in a rat model. Am J Surg, 1997, 174:359-363
28、Jacobi C A, Peter F J, Wenger F A,et al.New therapeutic strategies to
avoid intra-and extraperitoneal metastases. Dig-Surg, 1999, 16:393-9
29、Volz J, Volz Koster S, Kanis S,et al. Modulation of tumor-induced lethality after pneumoperitoneum in a mouse model..Cancer,2000,89: 262-6