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目的 为了进一步阐明腹腔镜肿瘤外科手术切口种植的原因,本文观察实验鼠CO2气腹对肿瘤细胞切口播散的影响。方法 雄性SD大鼠腹腔内注入不同量人胃癌细胞株SGC-7901,气腹机分别产生腹腔不同压力的持续性气腹,通过5mm腹腔穿刺管收集气体至培养瓶中,37℃、5％CO2环境中培养7天后,显微镜下鉴定是否有肿瘤细胞生长,另取腹腔冲洗液作阳性对照。结果 注入106/ml浓度的胃癌细胞,气腹压达30 mm Hg,流量为5L//min,持续60min、120min及180min后,部分培养瓶中发现有肿瘤细胞生长(P<0.001)。而在注入104/ml胃癌细胞所收集的气体中未发现肿瘤细胞。结论 106/ml肿瘤细胞数量下,高气腹压(30 mm Hg)、长时间(60min)是可以造成肿瘤细胞切口播散的。实验结果为临床上如何有效地预防腹腔镜肿瘤手术切口种植方面提供了参考依据,有一定的实用价值。
Objective In order to further elucidate the causes of surgical incision implantation in laparoscopic tumors, the effects of CO2 pneumoperitoneum on incision dissemination of tumor cells were observed in this study. Methods Male Sprague-Dawley rats were injected intraperitoneally with different doses of human gastric cancer cell line SGC-7901. The abdominal abdomen machines produced continuous pneumoperitoneum with different pressures in the abdomen. Gas was collected through a 5mm abdominal puncture tube into a culture flask. 37°C, 5% CO2. After 7 days of cultivation in the environment, the growth of tumor cells was identified under a microscope, and an additional abdominal fluid was taken as a positive control. Results After injecting 106/ml gastric cancer cells, the pneumoperitoneum pressure reached 30 mm Hg and the flow rate was 5 L//min. After 60 min, 120 min and 180 min, tumor cells were found to grow in some culture flasks (P<0.001). No tumor cells were found in the gas collected in 104/ml gastric cancer cells. Conclusion In the case of 106/ml tumor cells, high pneumoperitoneum pressure (30 mm Hg) and prolonged time (60 min) can cause tumor cell dissemination. The experimental results provide a reference for how to effectively prevent laparoscopic tumor incision implantation in clinical practice, which has certain practical value.