Port site metastases after laparoscopic colorectal surgery for cure of malignancy

Abstract

and the majority of patients have acute ulcers (65 per cent)'. NSAIDs are a common aetiological factor. Although the incidence of H. pylon has been shown to be independent of sex it correlates closely with socioeconomic class, with an increased incidence in the lower socioeconomic groups'. This fact may account for the high proportion of patients infected with H. pylon in this study. In their study from Glasgow, Reinbach et aL3 found that only 47 per cent of patients presenting with acute perforated duodenal ulcer were positive for H. pylori, as opposed to 50 per cent of control patients. Thus, we agree that management of these patients should include closure of their perforation and therapy aimed at healing the ulcer. However, based on the present evidence it would not be cost-effective blindly to attempt to eradicate H. pylon in acute perforated duodenal ulcers as there is no evidence to suggest that it plays a specific role in their pathogenesis.A. G. Patel S. J. Price P. U. Reber Norfolk and Nonvich Health Care NHS. Tmst Brunswick Road Nonvich Norfolk NRl3SR UK 1 Watkins RM, Dennison AR, Collin J. What has happened to perforated peptic ulcer? Br J Surg 1984; 71: 774-6. 2 Graham DY, Malty HM, Evans DG, Evans DJ Jr, Klein PD, Adam E. Epidemiology of Helicobacter pylon in an asymptomatic population in the United States. Effect of age, race and socioeconomic status. Gastroenterology 1991; 1 0 0 3 Reinbach DH, Cruickshank G, McColl KEL. Acute perforated duodenal ulcer is not associated with Helicobacter pylon infection.

Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

“…Prior reports suggested that high and/or pulsatile pneumoperitoneum, especially in lengthy procedures, may enhance migration tumor cells from the venous plexus of the bladder (whose pedicles are squeezed throughout the procedure) and contribute to early tumor recurrence 8,28,29 31 . However, the lymph node yield in the same study was the same for either approach and the differences reported were not statistically significant.…”

Surgical smoke: a review of the literature

“…The localized inflammation from the trauma induced by the cannula and trocar insertion increases the potential for a tumor cell to implant. This phenomenon was first suggested in 1995 in a letter to the British Journal of Surgery [63]. This phenomenon was further elucidated the following year in a study that suggested that the presence of a pneumoperitoneum creates a pressure gradient with a subsequent outflow of gas and floating tumor cells through the port wounds, creating a chimney effect that does not occur in a standard wound [64].…”

Port-site Metastasis after Minimally Invasive Surgery for Urological Malignancy: A Review of Literature

“…17 Tumor cells implant more easily and successfully during early wound healing, adhering to fibrin deposited at the site of surgical wound as a part of normal healing. 18 The presence of growth factors at the wound site promotes the survival and propagation of these cancer cells. As suggested by few animal studies, the port-site incision is more conducive than the laparotomy incision for tumor seeding.…”