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C. A. Jacobi - One of the best experts on this subject based on the ideXlab platform.
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the influence of adhesion prophylactic substances and taurolidine heparin on local recurrence and Intraperitoneal tumor growth after laparoscopic assisted bowel resection of colon carcinoma in a rat model
Surgical Endoscopy and Other Interventional Techniques, 2003Co-Authors: I Opitz, Chris Braumann, H Van Der Veen, B Ablassmaier, K Fuhrer, C. A. JacobiAbstract:Backgroud: The goal of the study was to investigate the influence of adhesion prophylactic substances (Interceed/lntergel) as well as taurolidine/heparin on Intraperitoneal tumor growth and the local recurrence rate after laparoscopic cecum resection in a rat tumor model. Methods: Sixty BDIX rats were randomized in three therapy groups and one control group. A laparoscopic-assisted cecum resection was performed via three-trocar method after Intraperitoneal tumor cell application (10,000 cells) of a colon carcinoma cell line (DHD/K1/TRb) in all animals. According to the randomization, the cecum suture and a 1 × 1-cm peritoneal defect were either covered with Intergel/Interceed or 1 ml of 0.5% taurolidine 10 IU heparin. The control group underwent instillation of 1 ml 0.9% NaCl solution. After 4 weeks the animals were euthanized and Intraperitoneal tumor growth, local recurrence rate, and the number of Intraperitoneal adhesions were determined. Results: The local recurrence rate was not significantly affected by any of the substances. Nevertheless, taurolidine/heparin significantly reduced the total number and weight of Intraperitoneal metastases. The formation of adhesions was not significantly influenced by adhesion prophylaxis substances or by taurolidine/heparin. Conclusions: Taurolidine/heparin led to a significant reduction of Intraperitoneal tumor growth after Intraperitoneal application, whereas local tumor recurrence was not significantly influenced. This might be due to the number of injected tumor cells in this cell suspension model. Interceed and Intergel did not reduce Intraperitoneal tumor growth. Furthermore, adhesion formation was not reduced by any of the substances.
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local and systemic chemotherapy with taurolidine and taurolidine heparin in colon cancer bearing rats undergoing laparotomy
Clinical & Experimental Metastasis, 2003Co-Authors: Chris Braumann, J. Ordemann, F. A. Wenger, M Kilian, C. A. JacobiAbstract:Experimental studies in the therapy of malignant abdominal tumors have shown that different cytotoxic agents suppress the Intraperitoneal tumor growth. Nevertheless, a general accepted approach to prevent tumor recurrences does not exist. Following subcutaneous and Intraperitoneal injection of 104 colon adenocarcinoma cells (DHD/K12/TRb), the influences of both taurolidine or taurolidine/heparin on Intraperitoneal and subcutaneous tumor growth was investigated in 105 rats undergoing midline laparotomy. The animals were randomized into 7 groups and operated on during 30 min. To investigate the Intraperitoneal (local) influence of either taurolidine or heparin on tumor growth, the substances were applied Intraperitoneally. Systemic and Intraperitoneal effects were evaluated after intravenous injection of the substances. Both application forms were also combined to analyze synergistic effects. Tumor weights, as well as the incidence of abdominal wound metastases, were determined four weeks after the intervention. In order to evaluate the effects of the agents, blood was taken to determine the peripheral leukocytes counts. Intraperitoneal tumor growth in rats receiving Intraperitoneal application of taurolidine (median 7.0 mg, P=0.05) and of taurolidine/heparin (median 0 mg, P=0.02) was significantly reduced when compared to the control group (median 185 mg). The simultaneous instillation of both agents also reduced the Intraperitoneal tumor growth (median 4 mg, P=0.04), while the intravenous injection of the substances caused no local effect. In contrast, the subcutaneous tumor growth did not differ among all groups. In all groups, abdominal wound recurrences were rare and did not differ. Independent of the agents and the application form, the operation itself caused a slight leukopenia shortly after the operation and a leukocytosis in the following course. Intraperitoneal therapy of either taurolidine or in combination with heparin inhibits local tumor growth and abdominal wound recurrences in rats undergoing midline laparotomy. Neither the Intraperitoneal nor the intravenous application or the combination of the two agents influenced the subcutaneous tumor growth. The substances did not alter the changes of peripheral leukocytes.
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influence of Intraperitoneal and systemic application of taurolidine and taurolidine heparin during laparoscopy on Intraperitoneal and subcutaneous tumour growth in rats
Clinical & Experimental Metastasis, 2000Co-Authors: Chris Braumann, Jürgen Ordemann, Peer Wildbrett, C. A. JacobiAbstract:Background: Recent clinical and experimental studies investigated the problem and possible pathomechanisms of port-site metastases after laparoscopic resection of malignant tumours. A generally accepted approach to prevent these tumour implantations does not exist so far. Methods: After subcutaneous and Intraperitoneal injection of 104 cells of colon adenocarcinoma (DHD/K12/TRb) the influences of either taurolidine or taurolidine/heparin on Intraperitoneal and subcutaneous tumour growth were investigated in 105 rats undergoing laparoscopy with carbon dioxide. The animals were then randomised into seven groups. A pneumoperitoneum was established using carbon dioxide for 30 min (8 mmHg). Three incisions were used: median for the insufflation needle, and a right and left approach in the lower abdomen for trocars. To investigate the Intraperitoneal (local) influence of either taurolidine and heparin on tumour growth the substances were instilled Intraperitoneally. Systemic effects were expected when the substances were applied intravenously (iv). Synergistic influences were tested when both application forms were combined. The number and the weight of tumours as well as the incidence of abdominal wall and port-site metastases were determined four weeks after intervention. Blood was taken to evaluate the influences of taurolidine and heparin on systemic immunologic reactions: seven days before laparoscopy, two hours, two days, seven days, and four weeks after operation, and the peripheral lymphocytes were determined. Results: Intraperitoneal (ip) tumour weight in rats receiving taurolidine (median 7 mg) and taurolidine/heparin (0 mg) Intraperitoneally was significantly reduced when compared to the control group (52 mg) (P=0.001). There was no difference of subcutaneus tumour growth among the groups (P=0.4). Trocar recurrences were decreased when taurolidine was applied ip (3/15), ipiv (4/15), and ip in combination with heparin (4/15) in comparison to the control group (10/15). Immediately after intervention treated and untreated groups showed a peripheral lymphopenia. Conclusions: The Intraperitoneal therapy with taurolidine and the combination with heparin inhibits the Intraperitoneal tumour growth and trocar recurrences. Neither the Intraperitoneal nor the systemic application or the combination of taurolidine and heparin did reduce the subcutaneous tumour growth. The intervention caused a lymphopenia which was compensated on day two.
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experimental study of the effect of intra abdominal pressure during laparoscopy on tumour growth and port site metastasis
British Journal of Surgery, 1998Co-Authors: C. A. Jacobi, F. A. Wenger, J. Ordemann, C. N. Gutt, R. Sabat, J. M. MüllerAbstract:Background The influence of raised Intraperitoneal pressure during laparoscopy on tumour growth and port site metastasis is still unknown. Methods Tumour growth of colonic adenocarcinoma DHD/K12/TRb was measured after laparoscopy with carbon dioxide at different pressures (0, 5, 10 and 15 mmHg) in a rat model. Cell kinetics were determined after incubation with carbon dioxide (0, 5, 10 and 15 mmHg) in vitro (n = 60). Additionally, tumour growth was measured subcutaneously and Intraperitoneally 4 weeks after laparoscopy at different Intraperitoneal pressures (5, 10 and 15 mmHg) (n = 100). Results In vitro tumour growth decreased significantly after incubation with carbon dioxide at 10 and 15 mmHg compared with a pressure of 0 or 5 mmHg. In vivo, mean(s.d.) Intraperitoneal tumour weight was significantly increased after laparoscopy at 5 mmHg (919(1085) mg) and at 10 mmHg (1274(1523) mg) (P < 0·05), but decreased again after laparoscopy with an Intraperitoneal pressure of 15 mmHg (731(929) mg) compared with the control group (365(353) mg) (P = 0·3). Mean(s.d.) subcutaneous tumour growth was promoted after laparoscopy at 5 mmHg (172(234) mg), at 10 mmHg (190(253) mg) and at 15 mmHg (178(194) mg) compared with controls (48(33) mg) (P < 0·05). Conclusion In vitro, raised Intraperitoneal pressure leads to suppression of tumour growth. In vivo, Intraperitoneal tumour growth is suppressed only by higher pressure (15 mmHg). Subcutaneous tumour growth is stimulated by carbon dioxide independently of the Intraperitoneal pressure. © 1998 British Journal of Surgery Society Ltd
Chris Braumann - One of the best experts on this subject based on the ideXlab platform.
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the influence of adhesion prophylactic substances and taurolidine heparin on local recurrence and Intraperitoneal tumor growth after laparoscopic assisted bowel resection of colon carcinoma in a rat model
Surgical Endoscopy and Other Interventional Techniques, 2003Co-Authors: I Opitz, Chris Braumann, H Van Der Veen, B Ablassmaier, K Fuhrer, C. A. JacobiAbstract:Backgroud: The goal of the study was to investigate the influence of adhesion prophylactic substances (Interceed/lntergel) as well as taurolidine/heparin on Intraperitoneal tumor growth and the local recurrence rate after laparoscopic cecum resection in a rat tumor model. Methods: Sixty BDIX rats were randomized in three therapy groups and one control group. A laparoscopic-assisted cecum resection was performed via three-trocar method after Intraperitoneal tumor cell application (10,000 cells) of a colon carcinoma cell line (DHD/K1/TRb) in all animals. According to the randomization, the cecum suture and a 1 × 1-cm peritoneal defect were either covered with Intergel/Interceed or 1 ml of 0.5% taurolidine 10 IU heparin. The control group underwent instillation of 1 ml 0.9% NaCl solution. After 4 weeks the animals were euthanized and Intraperitoneal tumor growth, local recurrence rate, and the number of Intraperitoneal adhesions were determined. Results: The local recurrence rate was not significantly affected by any of the substances. Nevertheless, taurolidine/heparin significantly reduced the total number and weight of Intraperitoneal metastases. The formation of adhesions was not significantly influenced by adhesion prophylaxis substances or by taurolidine/heparin. Conclusions: Taurolidine/heparin led to a significant reduction of Intraperitoneal tumor growth after Intraperitoneal application, whereas local tumor recurrence was not significantly influenced. This might be due to the number of injected tumor cells in this cell suspension model. Interceed and Intergel did not reduce Intraperitoneal tumor growth. Furthermore, adhesion formation was not reduced by any of the substances.
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local and systemic chemotherapy with taurolidine and taurolidine heparin in colon cancer bearing rats undergoing laparotomy
Clinical & Experimental Metastasis, 2003Co-Authors: Chris Braumann, J. Ordemann, F. A. Wenger, M Kilian, C. A. JacobiAbstract:Experimental studies in the therapy of malignant abdominal tumors have shown that different cytotoxic agents suppress the Intraperitoneal tumor growth. Nevertheless, a general accepted approach to prevent tumor recurrences does not exist. Following subcutaneous and Intraperitoneal injection of 104 colon adenocarcinoma cells (DHD/K12/TRb), the influences of both taurolidine or taurolidine/heparin on Intraperitoneal and subcutaneous tumor growth was investigated in 105 rats undergoing midline laparotomy. The animals were randomized into 7 groups and operated on during 30 min. To investigate the Intraperitoneal (local) influence of either taurolidine or heparin on tumor growth, the substances were applied Intraperitoneally. Systemic and Intraperitoneal effects were evaluated after intravenous injection of the substances. Both application forms were also combined to analyze synergistic effects. Tumor weights, as well as the incidence of abdominal wound metastases, were determined four weeks after the intervention. In order to evaluate the effects of the agents, blood was taken to determine the peripheral leukocytes counts. Intraperitoneal tumor growth in rats receiving Intraperitoneal application of taurolidine (median 7.0 mg, P=0.05) and of taurolidine/heparin (median 0 mg, P=0.02) was significantly reduced when compared to the control group (median 185 mg). The simultaneous instillation of both agents also reduced the Intraperitoneal tumor growth (median 4 mg, P=0.04), while the intravenous injection of the substances caused no local effect. In contrast, the subcutaneous tumor growth did not differ among all groups. In all groups, abdominal wound recurrences were rare and did not differ. Independent of the agents and the application form, the operation itself caused a slight leukopenia shortly after the operation and a leukocytosis in the following course. Intraperitoneal therapy of either taurolidine or in combination with heparin inhibits local tumor growth and abdominal wound recurrences in rats undergoing midline laparotomy. Neither the Intraperitoneal nor the intravenous application or the combination of the two agents influenced the subcutaneous tumor growth. The substances did not alter the changes of peripheral leukocytes.
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influence of Intraperitoneal and systemic application of taurolidine and taurolidine heparin during laparoscopy on Intraperitoneal and subcutaneous tumour growth in rats
Clinical & Experimental Metastasis, 2000Co-Authors: Chris Braumann, Jürgen Ordemann, Peer Wildbrett, C. A. JacobiAbstract:Background: Recent clinical and experimental studies investigated the problem and possible pathomechanisms of port-site metastases after laparoscopic resection of malignant tumours. A generally accepted approach to prevent these tumour implantations does not exist so far. Methods: After subcutaneous and Intraperitoneal injection of 104 cells of colon adenocarcinoma (DHD/K12/TRb) the influences of either taurolidine or taurolidine/heparin on Intraperitoneal and subcutaneous tumour growth were investigated in 105 rats undergoing laparoscopy with carbon dioxide. The animals were then randomised into seven groups. A pneumoperitoneum was established using carbon dioxide for 30 min (8 mmHg). Three incisions were used: median for the insufflation needle, and a right and left approach in the lower abdomen for trocars. To investigate the Intraperitoneal (local) influence of either taurolidine and heparin on tumour growth the substances were instilled Intraperitoneally. Systemic effects were expected when the substances were applied intravenously (iv). Synergistic influences were tested when both application forms were combined. The number and the weight of tumours as well as the incidence of abdominal wall and port-site metastases were determined four weeks after intervention. Blood was taken to evaluate the influences of taurolidine and heparin on systemic immunologic reactions: seven days before laparoscopy, two hours, two days, seven days, and four weeks after operation, and the peripheral lymphocytes were determined. Results: Intraperitoneal (ip) tumour weight in rats receiving taurolidine (median 7 mg) and taurolidine/heparin (0 mg) Intraperitoneally was significantly reduced when compared to the control group (52 mg) (P=0.001). There was no difference of subcutaneus tumour growth among the groups (P=0.4). Trocar recurrences were decreased when taurolidine was applied ip (3/15), ipiv (4/15), and ip in combination with heparin (4/15) in comparison to the control group (10/15). Immediately after intervention treated and untreated groups showed a peripheral lymphopenia. Conclusions: The Intraperitoneal therapy with taurolidine and the combination with heparin inhibits the Intraperitoneal tumour growth and trocar recurrences. Neither the Intraperitoneal nor the systemic application or the combination of taurolidine and heparin did reduce the subcutaneous tumour growth. The intervention caused a lymphopenia which was compensated on day two.
Yutaka Yonemura - One of the best experts on this subject based on the ideXlab platform.
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outcome data of patients with peritoneal carcinomatosis from gastric origin treated by a strategy of bidirectional chemotherapy prior to cytoreductive surgery and hyperthermic Intraperitoneal chemotherapy in a single specialized center in japan
Annals of Surgical Oncology, 2014Co-Authors: Emel Canbay, Haruaki Ishibashi, Shouzou Sako, Masamitsu Hirano, Akiyoshi Mizumoto, Masumi Ichinose, Nobuyuki Takao, Yutaka YonemuraAbstract:Background Management of peritoneal disseminated gastric cancer (GC) remains a challenging problem. The purpose of our study was to evaluate the outcome of bidirectional induction chemotherapy [bidirectional Intraperitoneal and systemic induction chemotherapy (BIPSC)] in patients with peritoneal carcinomatosis (PC) arising from GC who underwent cytoreductive surgery (CRS) and hyperthermic Intraperitoneal chemotherapy (HIPEC).
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outcome data of patients with peritoneal carcinomatosis from gastric origin treated by a strategy of bidirectional chemotherapy prior to cytoreductive surgery and hyperthermic Intraperitoneal chemotherapy in a single specialized center in japan
Annals of Surgical Oncology, 2014Co-Authors: Emel Canbay, Haruaki Ishibashi, Shouzou Sako, Masamitsu Hirano, Akiyoshi Mizumoto, Masumi Ichinose, Nobuyuki Takao, Yutaka YonemuraAbstract:Background Management of peritoneal disseminated gastric cancer (GC) remains a challenging problem. The purpose of our study was to evaluate the outcome of bidirectional induction chemotherapy [bidirectional Intraperitoneal and systemic induction chemotherapy (BIPSC)] in patients with peritoneal carcinomatosis (PC) arising from GC who underwent cytoreductive surgery (CRS) and hyperthermic Intraperitoneal chemotherapy (HIPEC).
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photodynamic detection and management of Intraperitoneal spreading of primary peritoneal papillary serous carcinoma in a man report of a case
Surgery Today, 2014Co-Authors: Emel Canbay, Haruaki Ishibashi, Shouzou Sako, Toshiyuki Kitai, Eisei Nishino, Masamitsu Hirano, Akiyoshi Mizumoto, Yoshio Endo, Shunichiro Ogura, Yutaka YonemuraAbstract:As a peritoneal surface malignancy, primary peritoneal papillary serous carcinoma (PPPSC) almost always occurs in women. Our search of the literature found only two previous case reports of men with PPPSC, both with very short survival. We report the case of a 63-year-old man with PPPSC, treated effectively with cytoreductive surgery and docetaxel-based hyperthermic Intraperitoneal chemotherapy following six cycles of docetaxel-based laparoscopic neoadjuvant Intraperitoneal and cisplatin-based systemic chemotherapy. Furthermore, we detected intraoperative Intraperitoneal spreading of the tumor after the oral administration of 5-amino levulinic acid (5-ALA). The patient remains in good health without ascites 18 months after his diagnosis. Thus, primary peritoneal papillary serous carcinoma should be managed by Intraperitoneal chemotherapy combined with peritonectomy procedures. Moreover, the intraoperative detection of the Intraperitoneal spreading of the tumor after administering oral 5-ALA shows that this is an exciting and promising diagnostic technique, which needs to be confirmed by further studies.
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extensive intraoperative peritoneal lavage as a standard prophylactic strategy for peritoneal recurrence in patients with gastric carcinoma
Annals of Surgery, 2009Co-Authors: Masafumi Kuramoto, Yutaka Yonemura, Shinya Shimada, Satosi Ikeshima, Akinobu Matsuo, Yasushi Yagi, Masakazu Matsuda, Hideo BabaAbstract:Objective:This prospective randomized multicenter study aims to evaluate the efficacy of extensive intraoperative peritoneal lavage followed by Intraperitoneal chemotherapy (EIPL-IPC) on the overall 5-year survival of advanced gastric cancer patients with Intraperitoneal free cancer cells without ov
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a systematic review and meta analysis of the randomized controlled trials on adjuvant Intraperitoneal chemotherapy for resectable gastric cancer
Annals of Surgical Oncology, 2007Co-Authors: Tristan D Yan, Deborah Black, Paul H Sugarbaker, J C Zhu, Yutaka Yonemura, George Petrou, David L MorrisAbstract:The purpose of this systematic review and meta-analysis was to determine the effectiveness and safety of adjuvant Intraperitoneal chemotherapy for patients with locally advanced resectable gastric cancer. Studies eligible for this systematic review included those in which patients with gastric cancer were randomly assigned to receive surgery combined with Intraperitoneal chemotherapy versus surgery without Intraperitoneal chemotherapy. There were no language restrictions. After independent quality assessment and data extraction, data were pooled for meta-analysis. Thirteen reports of randomized controlled trials (RCTs) were included for quality appraisal and data extraction. Ten reports were judged to be of fair quality and subjected to meta-analysis. A significant improvement in survival was associated with hyperthermic intraoperative Intraperitoneal chemotherapy (HIIC) alone (hazard ratio [HR] = 0.60; 95% CI = 0.43 to 0.83; p = 0.002) or HIIC combined with early postoperative Intraperitoneal chemotherapy (EPIC) (HR = 0.45; 95% CI = 0.29 to 0.68; p = 0.0002). There was a trend towards survival improvement with normothermic intraoperative Intraperitoneal chemotherapy (p = 0.06), but this was not significant with either EPIC alone or delayed postoperative Intraperitoneal chemotherapy. Intraperitoneal chemotherapy was also found to be associated with higher risks of intra-abdominal abscess (RR = 2.37; 95% CI = 1.32 to 4.26; p = 0.003) and neutropenia (RR = 4.33; 95% CI = 1.49 to 12.61; p = 0.007). The present meta-analysis indicates that HIIC with or without EPIC after resection of advanced gastric primary cancer is associated with improved overall survival. However, increased risk of intra-abdominal abscess and neutropenia are also demonstrated.
J. Ordemann - One of the best experts on this subject based on the ideXlab platform.
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local and systemic chemotherapy with taurolidine and taurolidine heparin in colon cancer bearing rats undergoing laparotomy
Clinical & Experimental Metastasis, 2003Co-Authors: Chris Braumann, J. Ordemann, F. A. Wenger, M Kilian, C. A. JacobiAbstract:Experimental studies in the therapy of malignant abdominal tumors have shown that different cytotoxic agents suppress the Intraperitoneal tumor growth. Nevertheless, a general accepted approach to prevent tumor recurrences does not exist. Following subcutaneous and Intraperitoneal injection of 104 colon adenocarcinoma cells (DHD/K12/TRb), the influences of both taurolidine or taurolidine/heparin on Intraperitoneal and subcutaneous tumor growth was investigated in 105 rats undergoing midline laparotomy. The animals were randomized into 7 groups and operated on during 30 min. To investigate the Intraperitoneal (local) influence of either taurolidine or heparin on tumor growth, the substances were applied Intraperitoneally. Systemic and Intraperitoneal effects were evaluated after intravenous injection of the substances. Both application forms were also combined to analyze synergistic effects. Tumor weights, as well as the incidence of abdominal wound metastases, were determined four weeks after the intervention. In order to evaluate the effects of the agents, blood was taken to determine the peripheral leukocytes counts. Intraperitoneal tumor growth in rats receiving Intraperitoneal application of taurolidine (median 7.0 mg, P=0.05) and of taurolidine/heparin (median 0 mg, P=0.02) was significantly reduced when compared to the control group (median 185 mg). The simultaneous instillation of both agents also reduced the Intraperitoneal tumor growth (median 4 mg, P=0.04), while the intravenous injection of the substances caused no local effect. In contrast, the subcutaneous tumor growth did not differ among all groups. In all groups, abdominal wound recurrences were rare and did not differ. Independent of the agents and the application form, the operation itself caused a slight leukopenia shortly after the operation and a leukocytosis in the following course. Intraperitoneal therapy of either taurolidine or in combination with heparin inhibits local tumor growth and abdominal wound recurrences in rats undergoing midline laparotomy. Neither the Intraperitoneal nor the intravenous application or the combination of the two agents influenced the subcutaneous tumor growth. The substances did not alter the changes of peripheral leukocytes.
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experimental study of the effect of intra abdominal pressure during laparoscopy on tumour growth and port site metastasis
British Journal of Surgery, 1998Co-Authors: C. A. Jacobi, F. A. Wenger, J. Ordemann, C. N. Gutt, R. Sabat, J. M. MüllerAbstract:Background The influence of raised Intraperitoneal pressure during laparoscopy on tumour growth and port site metastasis is still unknown. Methods Tumour growth of colonic adenocarcinoma DHD/K12/TRb was measured after laparoscopy with carbon dioxide at different pressures (0, 5, 10 and 15 mmHg) in a rat model. Cell kinetics were determined after incubation with carbon dioxide (0, 5, 10 and 15 mmHg) in vitro (n = 60). Additionally, tumour growth was measured subcutaneously and Intraperitoneally 4 weeks after laparoscopy at different Intraperitoneal pressures (5, 10 and 15 mmHg) (n = 100). Results In vitro tumour growth decreased significantly after incubation with carbon dioxide at 10 and 15 mmHg compared with a pressure of 0 or 5 mmHg. In vivo, mean(s.d.) Intraperitoneal tumour weight was significantly increased after laparoscopy at 5 mmHg (919(1085) mg) and at 10 mmHg (1274(1523) mg) (P < 0·05), but decreased again after laparoscopy with an Intraperitoneal pressure of 15 mmHg (731(929) mg) compared with the control group (365(353) mg) (P = 0·3). Mean(s.d.) subcutaneous tumour growth was promoted after laparoscopy at 5 mmHg (172(234) mg), at 10 mmHg (190(253) mg) and at 15 mmHg (178(194) mg) compared with controls (48(33) mg) (P < 0·05). Conclusion In vitro, raised Intraperitoneal pressure leads to suppression of tumour growth. In vivo, Intraperitoneal tumour growth is suppressed only by higher pressure (15 mmHg). Subcutaneous tumour growth is stimulated by carbon dioxide independently of the Intraperitoneal pressure. © 1998 British Journal of Surgery Society Ltd
F. A. Wenger - One of the best experts on this subject based on the ideXlab platform.
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local and systemic chemotherapy with taurolidine and taurolidine heparin in colon cancer bearing rats undergoing laparotomy
Clinical & Experimental Metastasis, 2003Co-Authors: Chris Braumann, J. Ordemann, F. A. Wenger, M Kilian, C. A. JacobiAbstract:Experimental studies in the therapy of malignant abdominal tumors have shown that different cytotoxic agents suppress the Intraperitoneal tumor growth. Nevertheless, a general accepted approach to prevent tumor recurrences does not exist. Following subcutaneous and Intraperitoneal injection of 104 colon adenocarcinoma cells (DHD/K12/TRb), the influences of both taurolidine or taurolidine/heparin on Intraperitoneal and subcutaneous tumor growth was investigated in 105 rats undergoing midline laparotomy. The animals were randomized into 7 groups and operated on during 30 min. To investigate the Intraperitoneal (local) influence of either taurolidine or heparin on tumor growth, the substances were applied Intraperitoneally. Systemic and Intraperitoneal effects were evaluated after intravenous injection of the substances. Both application forms were also combined to analyze synergistic effects. Tumor weights, as well as the incidence of abdominal wound metastases, were determined four weeks after the intervention. In order to evaluate the effects of the agents, blood was taken to determine the peripheral leukocytes counts. Intraperitoneal tumor growth in rats receiving Intraperitoneal application of taurolidine (median 7.0 mg, P=0.05) and of taurolidine/heparin (median 0 mg, P=0.02) was significantly reduced when compared to the control group (median 185 mg). The simultaneous instillation of both agents also reduced the Intraperitoneal tumor growth (median 4 mg, P=0.04), while the intravenous injection of the substances caused no local effect. In contrast, the subcutaneous tumor growth did not differ among all groups. In all groups, abdominal wound recurrences were rare and did not differ. Independent of the agents and the application form, the operation itself caused a slight leukopenia shortly after the operation and a leukocytosis in the following course. Intraperitoneal therapy of either taurolidine or in combination with heparin inhibits local tumor growth and abdominal wound recurrences in rats undergoing midline laparotomy. Neither the Intraperitoneal nor the intravenous application or the combination of the two agents influenced the subcutaneous tumor growth. The substances did not alter the changes of peripheral leukocytes.
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experimental study of the effect of intra abdominal pressure during laparoscopy on tumour growth and port site metastasis
British Journal of Surgery, 1998Co-Authors: C. A. Jacobi, F. A. Wenger, J. Ordemann, C. N. Gutt, R. Sabat, J. M. MüllerAbstract:Background The influence of raised Intraperitoneal pressure during laparoscopy on tumour growth and port site metastasis is still unknown. Methods Tumour growth of colonic adenocarcinoma DHD/K12/TRb was measured after laparoscopy with carbon dioxide at different pressures (0, 5, 10 and 15 mmHg) in a rat model. Cell kinetics were determined after incubation with carbon dioxide (0, 5, 10 and 15 mmHg) in vitro (n = 60). Additionally, tumour growth was measured subcutaneously and Intraperitoneally 4 weeks after laparoscopy at different Intraperitoneal pressures (5, 10 and 15 mmHg) (n = 100). Results In vitro tumour growth decreased significantly after incubation with carbon dioxide at 10 and 15 mmHg compared with a pressure of 0 or 5 mmHg. In vivo, mean(s.d.) Intraperitoneal tumour weight was significantly increased after laparoscopy at 5 mmHg (919(1085) mg) and at 10 mmHg (1274(1523) mg) (P < 0·05), but decreased again after laparoscopy with an Intraperitoneal pressure of 15 mmHg (731(929) mg) compared with the control group (365(353) mg) (P = 0·3). Mean(s.d.) subcutaneous tumour growth was promoted after laparoscopy at 5 mmHg (172(234) mg), at 10 mmHg (190(253) mg) and at 15 mmHg (178(194) mg) compared with controls (48(33) mg) (P < 0·05). Conclusion In vitro, raised Intraperitoneal pressure leads to suppression of tumour growth. In vivo, Intraperitoneal tumour growth is suppressed only by higher pressure (15 mmHg). Subcutaneous tumour growth is stimulated by carbon dioxide independently of the Intraperitoneal pressure. © 1998 British Journal of Surgery Society Ltd
