Detection of Aerosolized Cells during Carbon Dioxide Laparoscopy

Sayeed Ikramuddin, Joel Lucas, E. Christopher Ellison, William J. Schirmer, W. Scott Melvin

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Laparoscopic surgery for malignancy has been complicated by port-site recurrences. The exact mechanism has yet to be defined. In vitro studies suggest that carbon dioxide-induced tumor cell aerosolization may play a role. We have attempted to document this in a human model. Patients scheduled for elective laparoscopy underwent port placement and abdominal insufflation with carbon dioxide. A suction trap was then filled with 40 cc of normal saline solution and attached to an insufflation site on the port. The carbon dioxide effluent was directed through the saline. The specimen was concentrated, resuspended, and transferred to a slide. A Papanicolaou stain was used. Thirty-five specimens were obtained. Fifteen patients (37%) had malignant disease, which was metastatic in eight. Five patients had carcinomatosis. In two of those with carcinomatosis, staining revealed a large number of malignant cells. Malignant cells were not found in any other patients. In two patients, however, aerosolized mesothelial cells were identified. Follow-up ranged from 2 to 7 months. One patient who displayed cellular aerosolization developed a port-site recurrence. We conclude that malignant cells are aerosolized but only during laparoscopy in the presence of carcinomatosis. It is unlikely that tumor cell aerosolization contributes significantly to port-site metastasis.

Original languageEnglish (US)
Pages (from-to)580-584
Number of pages5
JournalJournal of Gastrointestinal Surgery
Volume2
Issue number6
StatePublished - Nov 1998
Externally publishedYes

Fingerprint

Carbon Dioxide
Laparoscopy
Insufflation
Carcinoma
Recurrence
Neoplasms
Suction
Sodium Chloride
Coloring Agents
Cell Count
Staining and Labeling
Neoplasm Metastasis

Keywords

  • Aerosolization
  • Carbon dioxide
  • Laparoscopy
  • Pneumoperitoneum
  • Tumor cell

ASJC Scopus subject areas

  • Surgery

Cite this

Ikramuddin, S., Lucas, J., Ellison, E. C., Schirmer, W. J., & Melvin, W. S. (1998). Detection of Aerosolized Cells during Carbon Dioxide Laparoscopy. Journal of Gastrointestinal Surgery, 2(6), 580-584.

Detection of Aerosolized Cells during Carbon Dioxide Laparoscopy. / Ikramuddin, Sayeed; Lucas, Joel; Ellison, E. Christopher; Schirmer, William J.; Melvin, W. Scott.

In: Journal of Gastrointestinal Surgery, Vol. 2, No. 6, 11.1998, p. 580-584.

Research output: Contribution to journalArticle

Ikramuddin, S, Lucas, J, Ellison, EC, Schirmer, WJ & Melvin, WS 1998, 'Detection of Aerosolized Cells during Carbon Dioxide Laparoscopy', Journal of Gastrointestinal Surgery, vol. 2, no. 6, pp. 580-584.
Ikramuddin S, Lucas J, Ellison EC, Schirmer WJ, Melvin WS. Detection of Aerosolized Cells during Carbon Dioxide Laparoscopy. Journal of Gastrointestinal Surgery. 1998 Nov;2(6):580-584.
Ikramuddin, Sayeed ; Lucas, Joel ; Ellison, E. Christopher ; Schirmer, William J. ; Melvin, W. Scott. / Detection of Aerosolized Cells during Carbon Dioxide Laparoscopy. In: Journal of Gastrointestinal Surgery. 1998 ; Vol. 2, No. 6. pp. 580-584.
@article{a4eec74d8af946e693a887f9b2741802,
title = "Detection of Aerosolized Cells during Carbon Dioxide Laparoscopy",
abstract = "Laparoscopic surgery for malignancy has been complicated by port-site recurrences. The exact mechanism has yet to be defined. In vitro studies suggest that carbon dioxide-induced tumor cell aerosolization may play a role. We have attempted to document this in a human model. Patients scheduled for elective laparoscopy underwent port placement and abdominal insufflation with carbon dioxide. A suction trap was then filled with 40 cc of normal saline solution and attached to an insufflation site on the port. The carbon dioxide effluent was directed through the saline. The specimen was concentrated, resuspended, and transferred to a slide. A Papanicolaou stain was used. Thirty-five specimens were obtained. Fifteen patients (37{\%}) had malignant disease, which was metastatic in eight. Five patients had carcinomatosis. In two of those with carcinomatosis, staining revealed a large number of malignant cells. Malignant cells were not found in any other patients. In two patients, however, aerosolized mesothelial cells were identified. Follow-up ranged from 2 to 7 months. One patient who displayed cellular aerosolization developed a port-site recurrence. We conclude that malignant cells are aerosolized but only during laparoscopy in the presence of carcinomatosis. It is unlikely that tumor cell aerosolization contributes significantly to port-site metastasis.",
keywords = "Aerosolization, Carbon dioxide, Laparoscopy, Pneumoperitoneum, Tumor cell",
author = "Sayeed Ikramuddin and Joel Lucas and Ellison, {E. Christopher} and Schirmer, {William J.} and Melvin, {W. Scott}",
year = "1998",
month = "11",
language = "English (US)",
volume = "2",
pages = "580--584",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "6",

}

TY - JOUR

T1 - Detection of Aerosolized Cells during Carbon Dioxide Laparoscopy

AU - Ikramuddin, Sayeed

AU - Lucas, Joel

AU - Ellison, E. Christopher

AU - Schirmer, William J.

AU - Melvin, W. Scott

PY - 1998/11

Y1 - 1998/11

N2 - Laparoscopic surgery for malignancy has been complicated by port-site recurrences. The exact mechanism has yet to be defined. In vitro studies suggest that carbon dioxide-induced tumor cell aerosolization may play a role. We have attempted to document this in a human model. Patients scheduled for elective laparoscopy underwent port placement and abdominal insufflation with carbon dioxide. A suction trap was then filled with 40 cc of normal saline solution and attached to an insufflation site on the port. The carbon dioxide effluent was directed through the saline. The specimen was concentrated, resuspended, and transferred to a slide. A Papanicolaou stain was used. Thirty-five specimens were obtained. Fifteen patients (37%) had malignant disease, which was metastatic in eight. Five patients had carcinomatosis. In two of those with carcinomatosis, staining revealed a large number of malignant cells. Malignant cells were not found in any other patients. In two patients, however, aerosolized mesothelial cells were identified. Follow-up ranged from 2 to 7 months. One patient who displayed cellular aerosolization developed a port-site recurrence. We conclude that malignant cells are aerosolized but only during laparoscopy in the presence of carcinomatosis. It is unlikely that tumor cell aerosolization contributes significantly to port-site metastasis.

AB - Laparoscopic surgery for malignancy has been complicated by port-site recurrences. The exact mechanism has yet to be defined. In vitro studies suggest that carbon dioxide-induced tumor cell aerosolization may play a role. We have attempted to document this in a human model. Patients scheduled for elective laparoscopy underwent port placement and abdominal insufflation with carbon dioxide. A suction trap was then filled with 40 cc of normal saline solution and attached to an insufflation site on the port. The carbon dioxide effluent was directed through the saline. The specimen was concentrated, resuspended, and transferred to a slide. A Papanicolaou stain was used. Thirty-five specimens were obtained. Fifteen patients (37%) had malignant disease, which was metastatic in eight. Five patients had carcinomatosis. In two of those with carcinomatosis, staining revealed a large number of malignant cells. Malignant cells were not found in any other patients. In two patients, however, aerosolized mesothelial cells were identified. Follow-up ranged from 2 to 7 months. One patient who displayed cellular aerosolization developed a port-site recurrence. We conclude that malignant cells are aerosolized but only during laparoscopy in the presence of carcinomatosis. It is unlikely that tumor cell aerosolization contributes significantly to port-site metastasis.

KW - Aerosolization

KW - Carbon dioxide

KW - Laparoscopy

KW - Pneumoperitoneum

KW - Tumor cell

UR - http://www.scopus.com/inward/record.url?scp=0032196198&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032196198&partnerID=8YFLogxK

M3 - Article

C2 - 10457317

AN - SCOPUS:0032196198

VL - 2

SP - 580

EP - 584

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 6

ER -