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Objective:To compare laparoscopic gastrectomy and conventional surgery on the dissemina- tion and seeding of tumor cells.Methods:Intraoperative peritoneal lavage cytologic examination was per- formed in 65 patients with gastric cancer,during laparoscopic gastrectomy(n=34)and conventional surgery(n=31).Cytology was examined twice,immediately after opening the peritoneal cavity and just before closing the abdomen.Saline was poured into the peritoneal cavity,and 100 ml fluid was retrieved after irrigation.Laparoscopic instruments were lavaged after surgery with 100 ml saline.Carbon dioxide (CO_2)was derived through the trocar side orifice after pneumoperitoneum during laparoscopic gastrectomy and filtered through 100 ml saline.Cytologic examination of the filtrate was performed after the filtration process.Results:The incidence of positive cytology during laparoscopic surgery was 32.26% in the preop- erative Iavage and 22.58% in the postoperative lavage.The incidence of positive cytology during conven- tional surgery was 41.18%0 before lavage and 26.47% after lavage.Only one positive cytology was detect- ed in the CO_2 filtrate gas.The incidence of positive cytology in the lavage of the instruments during laparo- scopic surgery was 6.45%.Conclusion:During gastric laparoscopic surgery,CO_2 pneumoperitoneum does not affect tumor cell dissemination and seeding.In this study,laparoscopic techniques used in gastric can- cer surgery were not associated with a higher risk for intraperitoneal dissemination of cancer cells than the conventional surgery.
Objective: To compare laparoscopic gastrectomy and conventional surgery on the dissemina- tion and seeding of tumor cells. Methods: Intraoperative peritoneal lavage cytologic examination was per- formed in 65 patients with gastric cancer, during laparoscopic gastrectomy (n = 34) and conventional surgery ( n = 31). Cytology was examined twice, immediately after opening the peritoneal cavity and just before closing the abdomen. Saline was poured into the peritoneal cavity, and 100 ml fluid was retrieved after irrigation. Laparoscopic instruments were lavaged after surgery with 100 ml saline .Carbon dioxide (CO 2) was derived through the trocar side orifice after pneumoperitoneum during laparoscopic gastrectomy and filtered through 100 ml saline. Cytologic examination of the filtrate was performed after the filtration process. Results: The incidence of positive cytology during laparoscopic surgery was 32.26% in the preop- erative Iavage and 22.58% in the postoperative lavage. incidence of positive cytology during conven- tional surgery was 41.18% 0 before lavage and 26.47% after lavage. One of one positive cytology was detect- ed in the CO 2 filtrate gas. The incidence of positive cytology in the lavage of the instruments during laparo- scopic surgery was 6.45% Conclusions: During gastric laparoscopic surgery, CO 2 pneumoperitoneum does not affect tumor cell dissemination and seeding. In this study, laparoscopic techniques used in gastric can- cer surgery were not associated with higher risk for intraperitoneal dissemination of cancer cells than the conventional surgery.