• 上海第二醫(yī)科大學(xué)附屬瑞金醫(yī)院普外科（上海200025）;

目的  探討腹腔鏡腫瘤外科手術(shù)中CO2氣腹對腫瘤細胞切口種植的影響。
方法  雄性SD大鼠腹腔內(nèi)注入不同濃度的人胃癌細胞株SGC-7901，氣腹機分別產(chǎn)生不同腹腔壓力［15 mm Hg/30 mm Hg（1 mm Hg=0.133 kPa）］的持續(xù)性氣腹，通過5 mm腹腔穿刺管收集氣體至培養(yǎng)瓶中，在37℃、5% CO2環(huán)境中培養(yǎng)7天后，涂片鑒定是否有腫瘤細胞生長，另取腹腔沖洗液作陽性對照。
結(jié)果  應(yīng)用106個/ml濃度的胃癌細胞液，氣腹壓達30 mm Hg，流量為5 L/min，持續(xù)5 min、60 min、120 min及180 min后，部分培養(yǎng)瓶中發(fā)現(xiàn)有腫瘤細胞生長； 而應(yīng)用104個/ml濃度的胃癌細胞液則未發(fā)現(xiàn)腫瘤細胞生長（P lt;0.001）。
結(jié)論  106個/ml胃癌細胞濃度下，高氣腹壓（30 mm Hg)、時間≥60 min可能造成腫瘤細胞的切口播散。本實驗結(jié)果為臨床上如何有效地預(yù)防腹腔鏡手術(shù)切口的腫瘤細胞種植提供了參考依據(jù)，具有臨床實用價值。

引用本文： 張浩波,王灝,鄭民華. 持續(xù)性CO2氣腹影響腹腔鏡手術(shù)切口腫瘤細胞種植的實驗研究. 中國普外基礎(chǔ)與臨床雜志, 2002, 9(1): 16-18. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

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11. Iwanaka T, Arya G,Ziegler MM. Mechanism and prevention of port site tumor recurrence after laparoscopy in a murine model [Ｊ].Pediatr Surg, 1998; 33(3)∶457.
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  2. 2. Lord SA, Larach SW, Ferrara A, et al. Laparoscopic resections in colorectal carcinoma： a threeyear experience [Ｊ].Dis Colon Rectum, 1996; 39(2)∶148.
  3. 3. Romos JM, Gupta S, Anthone GJ, et al. Laparoscopy and colon cancer： is the portsite at risk? A prelliminary report [Ｊ]. Arch Surg, 1994; 129(9)∶897.
  4. 4. Grocco WC, Schwartzman A, Golub RW. Abdominal wall recurrence after laparoscopic colectomy for colon cancer [Ｊ]. Surgery, 1994; 116(5)∶842.
  5. 5. Paik PS, Misawa T, Chiang M, et al. Abdominal incision tumor implantation following pneumoperitoneum laparoscopic procedure vs standard open incision in a syngeneic rat model [Ｊ]. Dis Colon Rectum, 1998; 41(4)∶419.
  6. 6. Wu JS, Brasfield EB, Guo LW, et al. Implantation of colon cancer at trocar sites is increased by low pressure pneumoperitoneum [Ｊ]. Surgery, 1997; 122(1)∶1.
  7. 7. Jacobi CA, Sabat R, Bohm B, et al. Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells [Ｊ]. Surgery, 1997; 121(1)∶72.
  8. 8. Whelan RL, Sellers GJ, Alleudorf JD, et al. Trocar site recurrence is unlikely to result from aerosolization of tumor cells [Ｊ]. Dis Colon Rectum,1996; 39(10)∶S7.
  9. 9. Asao T, Nagamachi T, Morinaga N, et al. Fucosyltransferase of the peritoneum contributed to the adhesion of cancer cells to the mesothelium [Ｊ]. Cancer, 1995; 75(6 Suppl)∶1539.
  10. 10. Asao T, Yazawa S, Kudo S, et al. A novel ex vivo method for assaying adhesion of cancer cells to the peritoneum [Ｊ]. Cancer Lett, 1994; 78(1-3)∶57.
  11. 11. Iwanaka T, Arya G,Ziegler MM. Mechanism and prevention of port site tumor recurrence after laparoscopy in a murine model [Ｊ].Pediatr Surg, 1998; 33(3)∶457.