Skip to main content
Log in

Port site metastasis after diagnostic laparoscopy for upper gastrointestinal tract malignancies: An uncommon entity

  • Original Articles
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The role of laparoscopy for diagnosing, staging, and treating intra-abdominal malignancies is increasing. This study was designed to examine the incidence of port site metastasis and open incision site metastasis for upper gastrointestinal tract (GI) malignancies.

Methods

From a prospective database maintained by the Department of Surgery, patients undergoing laparoscopy for upper GI malignancies were identified. Clinical outcomes and recurrences were noted.

Results

Between January 1993 and January 2001, 1965 laparoscopic procedures were identified. After those patients lost to follow-up were excluded, 1650 procedures were performed in 1548 patients. Port site implantation for all laparoscopies occurred in 13 (.79%) of 1650, with a median time to recurrence of 8.2 months. After laparotomy, open incision site recurrence occurred in 9 (.86%) of 1040 (not significant). Among the patients resected, there were 5 (.60%) of 830 port site recurrences and 7 (.84%) of 830 open incision site recurrences. At the time of diagnosis of recurrence, all of the patients with port site and five of seven with open site implantation had distant or local disease, or both, as well.

Conclusions

Port site implantation after diagnostic laparoscopy for upper GI malignancy is uncommon, does not seem to be different from open incision site recurrence, and occurs in the setting of advanced disease. Therefore, the risk of port site recurrence cannot be used as an argument against laparoscopy in upper GI malignancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Burke EC, Karpeh MS, Conlon KC, Brennan MF. Laparoscopy in the management of gastric adenocarcinoma.Ann Surg 1997; 225: 262–7.

    Article  PubMed  CAS  Google Scholar 

  2. McColloch P, Johnson M, Jairam R, Fischer W. Laparoscopic staging of gastric cancer is safe and affects treatment strategy.Ann R Coll Surg 1998; 80: 400–2.

    Google Scholar 

  3. Jimenez RE, Warshaw AL, Rattner DW, Willett CG, McGrath D, Fernandez-del Castillo C. Impact of laparoscopic staging in the treatment of pancreatic cancer.Arch Surg 2000; 135: 409–14.

    Article  PubMed  CAS  Google Scholar 

  4. Conlon KC, Brennan MF. Laparoscopy for staging abdominal malignancies.Adv Surg 2000; 34: 331–46.

    PubMed  CAS  Google Scholar 

  5. Jarnagin WR, Bodniewicz J, Dougherty E, Conlon K, Blumgart LH, Fong Y. A prospective analysis of staging laparoscopy in patients with primary and secondary hepatobiliary malignancies.J Gastroinest Surg 2000; 4: 34–43.

    Article  CAS  Google Scholar 

  6. Stockdale AD, Pocock TJ. Abdominal wall metastasis following laparoscopy: a case report.Eur J Surg Oncol 1985; 11: 373–5.

    PubMed  CAS  Google Scholar 

  7. Pezet D, Fondrinier E, Rotman N, et al. Peritoneal seeding of carcinoma of the gallbladder after laparoscopic cholecystectomy.Br J Surg 1992; 79: 230.

    Article  PubMed  CAS  Google Scholar 

  8. Fusco MA, Paluzzi MW. Abdominal wall recurrence after laparo-scopic-assisted colectomy for adenocarcinoma of the colon. Report of a case.Dis Colon Rectum 1993; 36: 858–61.

    Article  PubMed  CAS  Google Scholar 

  9. Dobronte Z, Wittman T, Karacsony G. Rapid development of malignant metastasis in the abdominal wall after laparoscopy.Endoscopy 1978; 10: 127–30.

    Article  PubMed  CAS  Google Scholar 

  10. Schaeff B, Paolucci V, Thomopoulos J. Port site recurrences after laparoscopic surgery. A review.Dig Surg 1998; 15: 124–34.

    Article  PubMed  CAS  Google Scholar 

  11. Ricardo AE, Feig BW, Ellis LM, et al. Gallbladder cancer and trocar site recurrences.Am J Surg 1997; 174: 619–23.

    Article  PubMed  CAS  Google Scholar 

  12. Paolucci V, Schaeff B, Schneider M, Gutt C. Tumor seeding following laproscopy: international survey.World J Surg 1999; 23: 989–97.

    Article  PubMed  CAS  Google Scholar 

  13. Pearlstone DB, Mansfield PF, Curley SA, Kumparatana M, Cook P, Feig BW. Laparoscopy in 533 patients with abdominal malignacy.Surgery 1999; 125: 67–72.

    PubMed  CAS  Google Scholar 

  14. Gleeson NC, Nicosia SV, Mark JE, Hoffman MS, Cavanagh D. Abdominal wall metastases from ovarian cancer after laparoscopy.Am J Obstet Gynecol 1993; 169: 522–3.

    PubMed  CAS  Google Scholar 

  15. Wexner SD, Cohen SM. Port site metastases after laparoscopic colorectal surgery for cure of malignancy.Br J Surg 1995; 82: 295–8.

    Article  PubMed  CAS  Google Scholar 

  16. Hughes ES, McDermott FT, Polglase AI, Johnson WR. Tumor recurrence in the abdominal wall scar tissue after large-bowel cancer surgery.Dis Colon Rectum 1983; 26: 571–2.

    Article  PubMed  CAS  Google Scholar 

  17. Fong Y, Brennan MF, Turnbull A, Coit DG, Blumgart LH. Gallbladder cancer discovered during laparoscopic surgery: potential for iatrogenic tumor dissemination.Arch Surg 1993; 128: 1054–6.

    PubMed  CAS  Google Scholar 

  18. van Dijkum EJN, de Wit LT, van Delden OM, et al. Staging laparoscopy and laparoscopic ultrasonography in more than 400 patients with upper gastrointestinal carcinoma.J Am Coll Surg 1999; 189: 459–65.

    Article  Google Scholar 

  19. Yamaguchi K, Hirabayashi Y, Suematsu T, Shiraishi N, Adachi Y, Kitano S. Hyaluronic acid secretion during carbon dioxide pneumoperitoneum and its association with port site metastasis in a murine model.Surg Endosc 2001; 15: 59–62.

    Article  PubMed  CAS  Google Scholar 

  20. Bouvy ND, Marquet RL, Jeekel H, Bonjer HJ. Impact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdominal wall metastases.Ann Surg 1996; 224: 694–701.

    Article  PubMed  CAS  Google Scholar 

  21. Jones DB, Guo L-W, Reinhard MK, et al. Impact of pneumoperitoneum on trocar site implantation of colon cancer in a hamster model.Dis Colon Rectum 1995; 38: 1182–8.

    Article  PubMed  CAS  Google Scholar 

  22. Reymond MA, Wittekind CH, Jung A, Hohenberger W, Kirchner TH, Kockerling F. The incidence of port site metastases might be reduced.Surg Endosc 1997; 11: 902–6.

    Article  PubMed  CAS  Google Scholar 

  23. Allendorf JDF, Bessler M, Horvath KD, Marvin MR, Laird DA, Whelan RL. Increased tumor establishment and growth after open vs laparoscopic bowel resection in mice.Surg Endosc 1998; 12: 1035–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kevin C. Conlon MD, MBA.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shoup, M., Breenan, M.F., Karpeh, M.S. et al. Port site metastasis after diagnostic laparoscopy for upper gastrointestinal tract malignancies: An uncommon entity. Annals of Surgical Oncology 9, 632–636 (2002). https://doi.org/10.1007/BF02574478

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02574478

Key Words

Navigation