Laparoscopy technique in the setting of peritoneal metastases to avoid port site relapse. [Review]

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Citation: Surgical Oncology. 37:101543, 2021 Jun.PMID: 33773282Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Abdominal Wall/pa [Pathology] | *Laparoscopy/mt [Methods] | *Neoplasm Recurrence, Local/pc [Prevention & Control] | *Peritoneal Neoplasms/sc [Secondary] | *Peritoneal Neoplasms/su [Surgery] | Humans | Laparoscopy/ae [Adverse Effects] | Margins of Excision | Neoplasm Metastasis | Neoplasm Recurrence, Local/et [Etiology] | Neoplasm Recurrence, Local/pa [Pathology]Year: 2021ISSN:
  • 0960-7404
Name of journal: Surgical oncologyAbstract: BACKGROUND: Laparoscopy is indicated in many patients with abdominal and pelvic malignancy. If cancer cells are present within the peritoneal space, there is a possibility for port site metastases to develop.CONCLUSION: Technical modifications of laparoscopy in patients with peritoneal metastases may reduce incidence of this iatrogenic dissemination of cancer. Copyright © 2021 Elsevier Ltd. All rights reserved.METHODS: The pathophysiology for occurrence of port site metastases was reviewed. Technical modifications to reduce the incidence of these abdominal wall sites for disease progression were suggested.RESULTS: Evacuation of all gases and all fluid from the peritoneal space through the trocars prior to their removal will reduce the contamination of the tissue surrounding the port site by intraperitoneal cancer cells. If port sites are confined to the midline, they can be removed as part of a midline abdominal incision if metastases occur. If port site metastases occur through lateral port sites, the rectus abdominus muscle may need to be widely excised to achieve negative margins.All authors: Craus-Miguel A, Morales-Soriano R, Pineno Flores C, Segura-Sampedro JJ, Sugarbaker PHFiscal year: FY2021Digital Object Identifier: Date added to catalog: 2022-12-13
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Journal Article MedStar Authors Catalog Article 33773282 Available 33773282

BACKGROUND: Laparoscopy is indicated in many patients with abdominal and pelvic malignancy. If cancer cells are present within the peritoneal space, there is a possibility for port site metastases to develop.

CONCLUSION: Technical modifications of laparoscopy in patients with peritoneal metastases may reduce incidence of this iatrogenic dissemination of cancer. Copyright © 2021 Elsevier Ltd. All rights reserved.

METHODS: The pathophysiology for occurrence of port site metastases was reviewed. Technical modifications to reduce the incidence of these abdominal wall sites for disease progression were suggested.

RESULTS: Evacuation of all gases and all fluid from the peritoneal space through the trocars prior to their removal will reduce the contamination of the tissue surrounding the port site by intraperitoneal cancer cells. If port sites are confined to the midline, they can be removed as part of a midline abdominal incision if metastases occur. If port site metastases occur through lateral port sites, the rectus abdominus muscle may need to be widely excised to achieve negative margins.

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