Search PubMed⌕ Search

Biomedical subjects

S Kitano

Publications and source records attributed to S Kitano.

At least 37 records · Page 2Linked to original sources
PubMed2002

Effects of carbon dioxide pneumoperitoneum on hemodynamics in cirrhotic rats.

BACKGROUND: The aim of our study was to investigate the effect of carbon dioxide pneumoperitoneum on systemic and splanchnic hemodynamics in cirrhotic rats. METHODS: Sprague-Dawley rats (n = 80) were used in this study. Liver cirrhosis was induced by thioacetamide administration intraperitoneally (200 mg/kg body weight, twice a week for 16 weeks). The radioactive microsphere method was used to measure systemic and regional hemodynamic parameters before, 1 h after the start, and 1 h after the release of pneumoperitoneum. RESULTS: Splanchnic blood flow and cardiac index were significantly depressed during pneumoperitoneum in liver cirrhosis and control groups, but no significant differences were seen between the two groups. In both groups, portal venous inflow decreased and hepatic arterial blood flow increased significantly during pneumoperitoneum. However, during pneumoperitoneum, total hepatic blood flow as a percentage of its value before pneumoperitoneum was lower in cirrhotic rats (71.0%) than in control rats (91.9%) (p <0.05, Mann-Whitney U-test). CONCLUSIONS: Carbon dioxide pneumoperitoneum markedly decreases total hepatic blood flow in cirrhotic rats due to the impaired hepatic arterial buffer response. Liver function should be carefully controlled in cirrhotic patients after laparoscopic surgery with pneumoperitoneum.

Animals↗
PubMed2002

Development of port-site metastasis after pneumoperitoneum.

BACKGROUND: Port-site metastasis is a critical problem in laparoscopic cancer surgery; the pathogenesis and means of prevention are still unclear. The aim of this study was to clarify by scanning electron microscopy the initial morphologic changes in the development of port-site metastasis. METHODS: Fifteen nude mice were injected with human gastric cancer (MKN 45) cells. Mice were killed on days 0, 3, and 8 (n = 5 each day) after intraperitoneal injection of 5 x 105 cancer cells and carbon dioxide (CO2) pneumoperitoneum at 4-6 mmHg for 20 min. The abdominal wall with the port sites was harvested and examined under both light and scanning electron microscopy. RESULTS: Immediately after CO2 pneumoperitoneum (day 0), the abdominal peritoneum was peeled away and the muscular layer was destroyed at the port site in all mice. Several cancer cells were attached to the injured port sites. On day 3, the subperitoneal tissue and muscular layer defects were replaced by granulation tissue, and several cancer cells were observed in the subperitoneal tissue. On day 8, a small nodule was macroscopically visible at the port site; it was completely covered by mesothelial cells and consisted of numerous cancer cells. CONCLUSIONS: Free cancer cells appear to attach to the injured port sites immediately after CO2 pneumoperitoneum, and these are associated with the development of port-site metastasis after laparoscopic cancer surgery.

Animals↗
PubMed2001

Evaluation of the cost for laparoscopic-assisted Billroth I gastrectomy.

BACKGROUND: Despite the rapid spread of laparoscopic gastric surgery in Japan, no one has yet evaluated the costs for this new technique. The aim of this study was to analyze and compare the hospital charges for laparoscopic-assisted gastrectomy with those for conventional open gastrectomy. METHODS: The study included 48 consecutive patients who underwent laparoscopic-assisted Billroth I gastrectomy and 43 who had a conventional open Billroth I gastrectomy for cure of early gastric cancer between May 1994 and April 2000. Hospital charges covered all costs incurred during the hospital stay; they were divided into charges for consultation, prescription, injection, nursing care, operating theater, laboratory, radiology, ward and meal, and others. RESULTS: The patients who underwent laparoscopic gastrectomy were similar to those who had open gastrectomy in terms of symptoms, concurrent illness, operation time, proximal resection margin, number of harvested lymph nodes, and stage of the disease. Hospital stay after laparoscopic gastrectomy was shorter than that after open gastrectomy (16.1 vs 20.5 days, p < 0.01). Charges for nursing care, charges for ward and meal, and total hospital charges were less in the laparoscopic group than in the open group ( yen5800 vs yen8010, p < 0.01; yen461 x 10(3) vs yen512 x 10(3), p < 0.05; yen1336 x 10(3) vs yen1411 x 10(3), p = 0.072). When we compared laparoscopic gastrectomies performed during 1994-96 with those done during 1997-2000, we found a decrease in charges for ward and meal and total hospital charges ( yen498 x 10(3) vs yen421 x 10(3), p < 0.01; yen1390 x 10(3) vs yen1277 x 103, p < 0.01). CONCLUSION: Laparoscopic-assisted Billroth I gastrectomy is less expensive than conventional open Billroth I gastrectomy because both the postoperative recovery period and the hospital stay are shorter. In patients who undergo gastrectomy, the additional costs of the disposable instruments can be fully offset by the lower charges for ward and meal and nursing care associated with laparoscopic gastrectomy.

Aged↗
PubMed2001

Morphology of the murine peritoneum after pneumoperitoneum vs laparotomy.

BACKGROUND: Although there have been studies of the effects of pneumoperitoneum on the peritoneal cavity, we still do not know whether the morphologic changes to the peritoneum are different for pneumoperitoneum vs laparotomy. Using scanning electron microscopy, we examined the murine peritoneum after pneumoperitoneum vs laparotomy and compared the changes. METHODS: Forty-five mice were anesthetized with diethyl ether and divided into seven groups. Pneumoperitoneum was established at 5 mmHg for 30 min with carbon dioxide (CO(2)) (n = 9), helium (n = 9), and air (n = 9). One group underwent laparotomy for 30 min (n = 9), and a control group underwent anesthesia only (n = 3). CO(2) pneumoperitoneum was further established at 10 mmHg for 30 min (n = 3) and at 5 mmHg for 60 min (n = 3). After the procedures, the peritoneum was resected from the mesenterium of the small intestine in each animal and examined by scanning electron microscope for morphologic changes of the mesothelial cells. RESULTS: Bulging up of the mesothelial cells was evident immediately after pneumoperitoneum, whereas detachment of the mesothelial cells was present immediately after laparotomy. Bulging up of the mesothelial cells was reduced at 24 h after CO(2) pneumoperitoneum and fully resolved at 72 h in all pneumoperitoneum groups, whereas the mesothelial cells remained detached at 72 h in the laparotomy group. Intercellular clefts were found immediately after helium pneumoperitoneum and were present at 24 h and 72 h after helium pneumoperitoneum, but they were not seen after air pneumoperitoneum and were only evident after CO(2) pneumoperitoneum at 10 mmHg. Depression of the mesothelial cell surface was observed when pneumoperitoneum lasted 60 min. CONCLUSION: Morphologic peritoneal alterations after pneumoperitoneum differed from those after laparotomy and were influenced by the type of gas, amount of pressure, and duration of insufflation. These peritoneal changes after pneumoperitoneum may be associated with a specific intraperitoneal tumor spread after laparoscopic cancer surgery.

Air↗
PubMed2001

Increased expression of P-cadherin mRNA in the mouse peritoneum after carbon dioxide insufflation.

BACKGROUND: Although systemic responses to carbon dioxide (CO(2)) pneumoperitoneum have been studied, there have been few reports of local responses within the peritoneum. We investigated the expression of mRNA for adhesion molecules involved in cell-cell interactions, including ICAM-1, VCAM-1, CD44, E-cadherin, P-cadherin, and N-cadherin, after the induction of a CO(2) pneumoperitoneum in mice. METHODS: Mice were treated with CO(2) pneumoperitoneum (4-6 mmHg for 30 min) and then killed after 24 h, 48 h, and 72 h. The peritoneum of the abdominal wall was resected, and total RNA was extracted by the acid guanidinium thiocyanate-phenol-chloroform extraction procedure, cDNA were synthesized by reverse transcription. Expression of the mRNA for each gene was normalized to that of b-actin for semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The expression of P-cadherin mRNA was significantly increased at 48 h (p = 0.007) and returned to the control level by 72 h after CO(2) pneumoperitoneum. The expression of CD44 increased gradually, reaching a peak at 48 h and returning to the control value by 72 h after CO(2) pneumoperitoneum. Expression of ICAM-1 mRNA was not changed significantly after the application of CO(2). CONCLUSION: The expression of P-cadherin mRNA in the peritoneum can be induced to repair injuries to mesothelial cells caused by CO(2) pneumoperitoneum.

Actins↗
PubMed2001

Assessment of donor fatty livers for liver transplantation.

AIM: The effect of fatty liver on graft survival, especially with reference to macrovesicular and microvesicular steatosis, is still uncertain. This preliminarily study was designed to create a noninvasive method for the quantification of the hepatic fat content in vivo and to establish provisional criteria for the assessment of fatty donor livers before liver transplantation among transplant surgeons, radiologists, and pathologists. METHODS AND MATERIALS: Different degrees of rat fatty liver model were established by feeding rats a diet deficient in choline and methionine for different periods of time. Computed tomography (CT) with test tubes containing variable percentages of fat equivalent substance were used to assess the severity of fatty change of the rat liver. This was then correlated with the histological classification, level of hepatic enzymes, and graft survival. RESULTS: Linear correlation between the fat volume fraction added to the test tubes and CT density were found. The process of producing a fatty liver via diet alteration peaked at week 3. At this time hepatic enzymes, radiological fat content, and posttransplantation survival were worse (P=0.013), compared with other time points. Radiological assessment of fatty liver correlated well with survival and serum glutamic oxaloacetic transaminase and glutamic pyruvate transaminase levels. CONCLUSION: Severe microvesicular steatosis does not influence recipient survival, however, macrovesicular steatosis affects graft survival. Caliber CT is a practical and simple method that allows an accurate noninvasive quantitative assessment of hepatic fatty infiltration. It has potential to be a useful parameter for the assessment of donor livers for clinical liver transplantation.

Animals↗
PubMed2001

Angiopoietin-2 is related to tumor angiogenesis in gastric carcinoma: possible in vivo regulation via induction of proteases.

Tumor angiogenesis progresses by a dynamic balance between tumor vascular regression and growth. Angiopoietin (Ang)-2 (the natural antagonist for the angiogenic Tie-2 receptor) and vascular endothelial growth factor (VEGF) are thought to be critical regulators in this process; therefore, these may play a critical role in cancer aggressiveness. The aim of this study was to clarify the clinical and biological significance of the expression of Ang-2 in human gastric cancers and to investigate the relationship between Ang-2 together with VEGF and the induction of proteases such as matrix metalloproteinases (MMPs) in the process of tumor development. Eighty-five individuals with gastric cancer, who had undergone surgery without preoperative treatment, were studied. A stable transfectant of the human MKN-7 gastric cancer cell lines with an Ang-2 expression vector was used for the experimental study. First, we examined the relationship between the mRNA expression of Angs by Northern blot analysis and clinicopathological features. High Ang-2-expression cases showed more frequent vascular involvement and more advanced stages of disease compared with low Ang-2-expression cases (P < 0.05). With regard to prognosis, the survival time for patients in the high-Ang-2 mRNA group was significantly shorter (P < 0.05). When we examined the localization of Ang-2 in human gastric cancers, immunohistochemical analysis revealed that this protein was expressed predominantly in cancer tissues when compared with normal tissues. Interestingly it was expressed not only in endothelia cells (ECs) but also in cancer cells. Second, Ang-2-transfected cells were implanted in vivo into the gastric walls of nude mice. Ang-2-transfectant mice developed highly metastatic tumors with hypervascularity as compared with MKN-7 or control vector-transfectant tumors. There was a significant correlation between Ang-2 mRNA expression and lower grade of vessel maturation. Third, on the basis of the in vivo data, we focused on production of proteases such as MMPs to investigate possible mechanisms in these processes. MMP-1, MMP-9, and urokinase-type plasminogen activator in ECs were strongly up-regulated by Ang-2 in the presence of VEGF in vitro. These data suggest that production of Ang-2 is implicated in tumor development in human gastric cancers. Its production may contribute to tumor angiogenesis by induction of proteases in ECs, which may be enhanced in the presence of VEGF.

Angiopoietin-2↗
PubMed2001

Clinicopathologic study of early-stage mucinous gastric carcinoma.

BACKGROUND: Mucinous gastric carcinoma (MGC) is rare, and whether MGC behaves more aggressively than nonmucinous gastric carcinoma (NGC) is controversial. To the authors' knowledge, there is no study of early-stage MGC, and the pathology and prognosis of patients who have early MGC is unknown. The aim of this study was to clarify the clinicopathologic characteristics of early MGC. METHODS: Pathologic and prognostic data of 30 patients who had early MGC were compared retrospectively against data of 165 patients who had early NGC and 58 patients who had advanced MGC. We defined MGC as a tumor in which more than half of the tumor area contained extracellular mucin pools. We defined early gastric carcinoma as a tumor restricted to the mucosa or to the mucosa and submucosa (T1, International Union Against Cancer [UICC], 1997) regardless of lymph node metastasis. RESULTS: Early MGC tumors, compared with early NGC tumors, were characterized by macroscopic elevation (57% vs. 23%, P < 0.01) and invasion to the submucosa (83% vs. 44%, P < 0.01). Tumor size, frequency of lymph node metastasis, and patient outcome did not differ between the two types, and no patient with early MGC died of recurrence during a median follow-up period of 67 months. When early MGC was compared with advanced MGC, tumor size (2.9 cm vs. 9.4 cm, P < 0.01), frequency of lymph node metastasis (10% vs. 88%,P < 0.01), total gastrectomy (0% vs. 52%, P < 0.01), noncurative surgery (0% vs. 38%, P < 0.01), and recurrent death (0% vs. 57%, P < 0.01) differed significantly. CONCLUSIONS: Our results indicated that although the macroscopic features of early MGC differed from those of early NGC, patient prognosis and the frequency of lymph node metastasis did not differ. Neither did mucinous histology seem to influence outcome adversely after gastrectomy.

Adenocarcinoma, Mucinous↗
PubMed2001

Enhancement of port site metastasis by hyaluronic acid under CO2 pneumoperitoneum in a murine model.

BACKGROUND: The mechanism underlying the development and progression of port site metastasis after laparoscopic surgery for cancer is still not understood. Hyaluronic acid secreted from mesothelial cells is thought to be a key factor that causes adhesion between cancer cells and mesothelial cells. Using a murine model of carbon dioxide (CO2) pneumoperitoneum, we evaluated the effect of exogenous hyaluronic acid on port site metastasis. METHODS: BALB/c mice were injected with 5 A- 106 human gastric carcinoma (MKN45) cells and divided into four groups treated with or without hyaluronic acid and with or without pneumoperitoneum. Three weeks later, the frequency and weight of port site metastases were determined. The effects of hyaluronic acid on tumorigenicity and tumor growth were examined in mice subcutaneously injected with MKN45 cells. RESULTS: Port site metastasis occurred significantly less frequently in the pneumoperitoneum-only group than in the pneumoperitoneum-with-hyaluronic-acid group (75% vs 100%, p < 0.05). The port site metastatic tumor weighed significantly less in the control group (anesthesia only) than in the hyaluronic acid group (89 +/- 17 vs 288 +/- 35 mg, p < 0.05); it also weighed less in the pneumoperitoneum-only group than in the pneumoperitoneum-with-hyaluronic-acid group(87 +/- 24 vs 298 +/- 51 mg, p < 0.05). The frequency and weight of tumors in the subcutaneous tissue were not significantly different between groups with or without hyaluronic acid injection (95% vs 90%, 331 +/- 128 vs 322 +/- 115 mg). CONCLUSIONS: Under CO2 pneumoperitoneum, exogenous hyaluronic acid increased the frequency and weight of port site metastasis in a murine model. Hyaluronic acid secreted from mesothelial cells may be associated with the formation of port site metastasis after laparoscopic surgery for cancer under pneumoperitoneum.

Adjuvants, Immunologic↗
PubMed2001

Clinicopathologic study of mixed hepatocellular and cholangiocellular carcinoma: modes of spreading and choice of surgical treatment by reference to macroscopic type.

BACKGROUND AND OBJECTIVES: Clinicopathologic features and the choice of surgical treatment for mixed hepatocellular and cholangiocellular carcinoma (MHC) remain controversial. METHODS: We evaluated the clinicopathological features of seven cases of MHC (one autopsied and six surgically resected cases). MHCs were divided into two classes by reference to macroscopic appearance: four were of the single nodular (SN) type and three were of the multinodular (MN) type. RESULTS: The mean age of patients and mean preoperative level of serum alpha-fetoprotein were 44.5 years and 56,457 ng/ml for the SN type and 63.7 years and 1,227 ng/ml for the MN type, respectively. Histologically, invasion of the portal vein, the hepatic vein, and the perineural space was found in three, two, and zero cases of SN type tumors and in three, three, and one cases of MN type tumors, respectively. Lymph node metastases were found only in two patients with MN type MHC. CONCLUSIONS: MHC of the SN type had a pattern of infiltration similar to hepatocellular carcinoma. By contrast, MHC of the MN type resembled intrahepatic cholangiocellular carcinoma. It is suggested that lymphadenectomy might be necessary for treatment of selected MHC, in particular MHC with a multinodular appearance.

Adult↗
PubMed2001

Pathology and prognosis of mucinous gastric carcinoma.

BACKGROUND AND OBJECTIVES: Clinicopathologic characteristics of mucinous gastric carcinoma (MGC) are unclear, and whether surgical results of MGC are unfavorable is controversial. Pathology and prognosis of patients with MGC were studied using multivariate analysis. METHODS: The study included 17 patients with MGC and 614 with nonmucinous gastric carcinoma (NGC). The tumor was defined as MGC when more than one half of tumor area had mucin pools. Patients were evaluated with regard to age, sex, tumor location, size, gross type, depth of wall invasion, lymph node metastasis, lymphatic and vascular permeations, stage of disease, and operative curability. RESULTS: MGC tumors, when compared with NGC tumors, were featured by the large size (9.0 vs. 5.2 cm), grossly infiltrative type (76 vs. 30%), T2 or more invasion (100 vs 53%), positive lymph node metastasis (88 vs. 32%), lymphatic permeation (94 vs. 55%), vascular permeation (47 vs. 25%), and stages III and IV (88 vs. 32%). On a multivariate analysis, mucinous histologic type was not an independent prognostic factor. Although 5-year survival rate for all MGC patients was lower than that for all NGC patients, the survival rate was not different between the MGC and NGC patients when compared in the same category of tumor size, depth of wall invasion, lymph node metastasis, and stage. CONCLUSIONS: MGC is rare and detected mostly in an advanced stage. Mucinous histologic type itself is not a prognostic significance in patients with gastric carcinoma, and the biologic behavior of MGC is similar to that of ordinary advanced gastric carcinoma.

Adenocarcinoma, Mucinous↗
PubMed2001

A case of endocrine ductal carcinoma of the breast.

A case of endocrine ductal carcinoma of the breast is presented. A 65-year-old woman was admitted with complaints of left breast mass and pain. Physical examination, mammography, ultrasonography, and computed tomography showed a mass 5 cm in diameter in the left breast suggestive of breast cancer, and incisional biopsy confirmed ductal carcinoma. Auchincloss's mastectomy was performed. The tumor, 4.0 x 3.8 cm in size, consisted of a relatively uniform proliferation of tumor cells with round nuclei and abundant eosinophilic cytoplasm. Immunohistochemically, tumors cells were positive for chromogranin A, synaptophysin, and neuron-specific enolase. Endocrine ductal carcinoma with invasion was diagnosed. No lymph node metastasis was observed, and estrogen and progesterone receptors were positive.

Aged↗
PubMed2001

Effect of periodic endoscopy for gastric cancer on early detection and improvement of survival.

BACKGROUND: Increases in the detection of early gastric cancer have indisputably, improved long-term survival. The aim of this study was to establish the value of periodic gastric endoscopy and the appropriate intervals for its performance. METHODS: We compared, retrospectively, the clinicopathologic characteristics and outcomes of two groups of patients who had undergone surgical treatment for gastric cancer. Of a total of 361 patients, 106 had undergone endoscopic examination within 2 years before the detection of gastric cancer (group 1), and 255 had either undergone no endoscopic examination or had had endoscopic examination more than 2 years before the detection of gastric cancer (group 2). For the evaluation of survival rate, the patients in each group were classified into two subgroups: group 1a, endoscopic examination within 1 year before detection; group 1b, endoscopic examination more than 1 year and within 2 years; group 2a, endoscopic examination more than 2 years and within 4 years before detection; and group 2b, endoscopic examination more than 4 years before detection, or no endoscopic examination. RESULTS: Gastric cancer in group 1 was characterized by small tumor size, no tumor invasion beyond the submucosa, few instances of lymphatic and vascular permeation, and few lymph node metastases. The 5-year survival rate for group 1 patients (96.5%) was significantly higher than that for group 2 patients (71.0%; P < 0.01). The survival rates for group 1a patients and group 1b patients were not significantly different (P = 0.4595). The survival rate for patients in group 2a was significantly lower than that for those in group 1a (P < 0.05). CONCLUSION: Periodic gastric endoscopy enables early detection of cancer, thereby improving survival. The optimal interval for periodic examination appears to be 2 years.

Aged↗
PubMed2001

Identification of two down-regulated genes in rat liver allografts by mRNA differential display.

Total RNA differential display (DD) using random primers was performed for rat orthotopic liver transplantation (OLT) models. DA (RT1a) donor livers were transplanted into DA, PVG (RT1c), and LEW (RT1l) recipients: (1) syngeneic OLT (DA-DA): no rejection occurs; (2) allogeneic OLT (DA-PVG): rejection occurs, but is naturally overcome without immunosuppression; (3) allogeneic OLT (DA-LEW): animals die of acute rejection within 14 days. cDNA was isolated from selected bands, re-amplified for sequencing, and confirmed by Northern blots. Two down-regulated genes were observed in day-7 allogeneic OLT livers (DA-PVG, DA-LEW), while they were consistently expressed in day-7 syngeneic OLT (DA-DA) livers. These two genes were identified as alpha-glutathione sulfotransferase (alpha-GST) Ya gene and estrogen sulfotransferase (EST), respectively. Northern blots confirmed that their expression was down-regulated in OLT (DA-PVG) livers on days 7-26 and gradually restored. The mRNA expression of GST and EST may be good markers to predict rejection or induction of tolerance.

Animals↗
PubMed2001

Leptomeningeal contrast enhancement in moyamoya: its potential role in postoperative assessment of circulation through the bypass.

Leptomeningeal contrast enhancement (LMCE) is one of the MRI features of moyamoya. Its clinical significance, however, is not elucidated. Our purpose was to characterise LMCE on MRI and to evaluate its role in the assessment of circulation through a surgically established bypass in moyamoya. We studied 16 patients with idiopathic moyamoya (seven males, nine females, includingt four children, aged 7 to 54 years, mean 24 years) who underwent T1-weighted MRI before and after intravenous contrast medium. The presence of LMCE, its intensity and anatomical distribution, catheter angiographic findings, and relation of LMCE to the bypass surgery were assessed. More LMCE was seen in the cerebrum in most patients with moyamoya than in normal controls. LMCE in the brain stem and cerebellum was minimal, similar to that seen in the controls. LMCE was less prominent following surgery than before operation or in patients who did not undergo surgery. In three patients examined both before and after operation LMCE became less prominent following bypass surgery. As LMCE becomes less prominent after "effective" bypass surgery, this may be used for evaluation of effectiveness of surgery in moyamoya.

Adult↗
PubMed2001

Hyaluronic acid secretion during carbon dioxide pneumoperitoneum and its association with port-site metastasis in a murine model.

BACKGROUND: The mechanism of port-site metastasis after laparoscopic cancer surgery is unclear. This study aimed to determine whether carbon dioxide (CO2) pneumoperitoneum caused an increase in hyaluronic acid, which is secreted from mesothelial cells of the peritoneal cavity, and to assess the risk for port-site metastasis using a murine pneumoperitoneal model. METHODS: Sandwich-binding protein assay was used to measure the concentration of hyaluronic acid in the peritoneal cavity at 6, 12, 18, 24, 48, and 72 h after CO2 pneumoperitoneum or laparotomy for 30 min. The concentrations of hyaluronic acid during pneumoperitoneum were compared among different gases (CO2, helium, air), intervals (5, 30, 60 min), and pressures (0-2, 4-6, 8-10 mmHg). To investigate the effects of exogenous hyaluronic acid, the development of port-site metastasis was examined using mouse adenocarcinoma cell-line colon 26 cells. RESULTS: The intraperitoneal concentration of hyaluronic acid after CO2 pneumoperitoneum had increased already at 6 h, had reached the maximum level at 24 h, and had begun to decrease at 72 h. The concentration of hyaluronic acid at 24 h and 48 h in the CO2 pneumoperitoneum group was higher than that in the laparotomy group. This increase in hyaluronic acid also was found during helium and air pneumoperitoneum, and the concentration of hyaluronic acid in the peritoneal cavity was at its maximum when CO2 pneumoperitoneum lasted 30 min at 4 to 6 mmHg. The frequency of port-site metastasis was the highest when hyaluronic acid was injected during CO2 pneumoperitoneum (100%). CONCLUSIONS: In a murine model, the intraperitoneal concentration of hyaluronic acid was significantly increased after CO2 pneumoperitoneum, and the increase was more evident than that after laparotomy. Increased hyaluronic acid during pneumoperitoneum may be associated with port-site metastasis after laparoscopic cancer surgery.

Adenocarcinoma↗
PubMed2001

The effect of gases in the intraperitoneal space on cytokine response and bacterial translocation in a rat model.

BACKGROUND: The aim of this study was to examine cytokine response and bacterial translocation after exposure of the intraperitoneal space to carbon dioxide (CO2), helium (He), and air (Air) in a rat model. METHODS: For this study, 120 Sprague-Dawley rats underwent anesthesia only (Control), 10 mmHg pneumoperitoneum (PP), or abdominal wall lift (AWL). The rats were divided into five groups according to experimental procedure: Control, PP-CO2, AWL-CO2, AWL-He, and AWL-Air. At 0, 3, 6, and 24 h after the procedures, the levels of interleukin 1beta (IL-1beta) and interleukin 6 (IL-6) in both plasma and peritoneal lavage fluid (PLF) were measured, and the translocation of bacteria to the mesenteric lymph nodes was evaluated. RESULTS: The plasma IL-1beta and IL-6 levels in the PP-CO2, AWL-CO2, and AWL-He groups were significantly lower than those in AWL-Air group at 6 h (p < 0.05). The PLF IL-1beta (at 3, 6, and 24 h) and IL-6 (at 6 h) levels in the AWL-CO2 group were significantly lower than those in the AWL-Air group (p < 0.05). There were no significant differences in IL-1beta and IL-6 responses among the PP-CO2, AWL-CO2, and AWL-He groups. The AWL-CO2 and PP-CO2 groups had lower incidences of bacterial translocation than did the AWL-Air group (p < 0.05). CONCLUSIONS: The results from this study suggest that the gas in the intraperitoneal space, but not the increased intraabdominal pressure, causes the alterations in host cytokine response and bacterial translocation. Carbon dioxide may play a primary role in the reduced immune response associated with laparoscopic surgery.

Animals↗