Present Situation and Prospect of Influence of CO2 Pneumoperitoneum on Invasion and Metastasis of Gastrointestinal Neoplasm_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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余佩武 , 郝迎学

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Keywords：

肿瘤; CO2; 气腹; 侵袭; 转移

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自1987年Mouret完成世界首例腹腔镜胆囊切除术以来，随着外科医生手术技术的不断提高和腹腔镜器械的逐渐改进，腹腔镜微创技术的应用范围越来越广泛，以腹腔镜为代表的微创外科已经成为21世纪外科发展的方向之一，其对胃肠道恶性肿瘤根治的可行性和手术安全性已经得到认可。已有多项RCT研究显示，腹腔镜结直肠癌手术与开腹手术具有相当的近、远期疗效，美国结直肠癌外科医师协会已将其列为治疗结直肠癌的标准手术方式之一。近年来，腹腔镜在胃癌根治术中的应用已逐渐由早期胃癌扩展到进展期胃癌，并取得了与开腹手术相当的近、中期疗效。但是人们对CO2 气腹是否有利于胃肠道肿瘤的侵袭、转移一直心存疑虑，随之一些有关腹腔镜技术中不同种类、不同压力的气腹与胃肠道肿瘤侵袭、转移关系的研究报道相继出现,不同学者报道结果有较大差异，有些学者认为CO2气腹有利于胃肠道肿瘤的侵袭、转移; 而有些学者却认为CO2气腹对胃肠道肿瘤的侵袭、转移无显著影响。..................

Citation： 余佩武,郝迎学. Present Situation and Prospect of Influence of CO2 Pneumoperitoneum on Invasion and Metastasis of Gastrointestinal Neoplasm. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(10): 777-780. doi: Copy

1.	Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer [J]. N Engl J Med, 2004; 350(20): 2050-2059.
2.	Braga M, Frasson M, Vignali A, et al. Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival [J]. Dis Colon Rectum, 2005; 48(12): 2217-2223.
3.	郑民华，蔡景理，陆爱国，等. 腹腔镜手术治疗结直肠癌安全性的临床研究 [J]. 外科理论与实践, 2003; 8(5): 361-364.
4.	余佩武，钱锋，罗华星，等. 腹腔镜胃癌根治术的临床疗效 [J]. 中华消化外科杂志, 2008; 7(1): 38-40.
5.	Memon MA, Khan S, Yunus RM, et al. Meta-analysis of laparoscopic and open distal gastrectomy for gastric carcinoma [J]. Surg Endosc, 2008; 22(8): 1781-1789.
6.	Gutt CN, Kim ZG, Hollander D, et al. CO2 environment influences the growth of cultured human cancer cells dependent on insufflation pressure [J]. Surg Endosc, 2001; 15(3): 314-318.
7.	Wittich P, Steyerberg EW, Simons SH, et al. Intraperitoneal tumor growth is influenced by pressure of carbon dioxide pneumoperitoneum [J]. Surg Endosc, 2000; 14(9): 817-819.
8.	石彦，郝迎学，雷晓，等. 模拟CO2气腹对人胃癌MKN-45细胞增殖和细胞周期的影响 [J]. 第三军医大学学报, 2007; 29(23): 2274-2276.
9.	Hao YX, Zhong H, Zhang C, et al. Effects of simulated carbon dioxide and helium peumoperitoneum on proliferation and apoptosis of gastric cancer cells [J]. World J Gastroenterol, 2008; 14(14): 2241-2245.
10.	Tomita H, Marcello PW, Milsom JW, et al. CO2 pneumoperitoneum does not enhance tumor growth and metastasis: study of a rat cecal wall inoculation model [J]. Dis Colon Rectum, 2001; 44(9): 1297-1301.
11.	郑民华，马君俊，冯波，等. 不同压强持续性CO2对结肠癌细胞侵袭转移的影响 [J]. 中华实验外科杂志, 2005; 22(10): 1164-1166.
12.	郝迎学，钟华，张超，等. 体外模拟气腹环境对胃癌细胞增殖凋亡的影响 [J]. 中国微创外科杂志, 2008; 8(6): 552-555.
13.	郝迎学，钟华，曾冬竹，等. 缺氧诱导因子1α对CO2气腹环境下人胃癌细胞凋亡的影响 [J]. 中华普通外科杂志， 2008; 43(6): 460-463.
14.	Kim ZG, Mehl C, Lorenz M, et al. Impact of laparoscopic CO2-insufflation on tumor-associated molecules in cultured colorectal cancer cells [J]. Surg Endosc, 2002; 16(8): 1182-1186.
15.	Paraskeva PA. Hypoxic pneumoperitoneum initiates the metastatic cascade in colon cancer cells [J]. Br J Surg, 2000; 87(suppl 1): 3.
16.	郑民华，马君俊，冯波，等. CO2气腹对结肠癌细胞粘附能力影响及其与粘附分子的关系 [J]. 中国实用外科杂志, 2005; 25(11): 668-670.
17.	郝迎学，钟华，曾冬竹，等. 不同压力二氧化碳气腹对胃癌细胞增殖运动的影响 [J]. 中华消化外科杂志, 2008; 7(1): 56-58.
18.	郝迎学，钟华，张超，等. 不同压力二氧化碳气腹对胃癌细胞迁移运动和细胞骨架的影响 [J]. 中华胃肠外科杂志, 2008; 11(5): 454-457.
19.	石彦，钱锋，郝迎学，等. 二氧化碳气腹对胃癌MKN-45细胞侵袭能力的影响 [J]. 中华消化外科杂志, 2007; 6(6): 449-451.
20.	Wildbrett P, Oh A, Naundorf D, et al. Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function [J]. Surg Endosc, 2003; 17(1): 78-82.
21.	Duerr FM, Twedt DC, Monnet E. Changes in pH of peritoneal fluid associated with carbon dioxide insufflation during laparoscopic surgery in dogs [J]. Am J Vet Res, 2008; 69(2): 298-301.
22.	Volz J, Kster S, Spacek Z, et al. Characteristic alterations of the peritoneum after carbon dioxide pneumoperitoneum [J]. Surg Endosc, 1999; 13(6): 611-614.
23.	Jacobi CA, Sabat R, Bhm B, et al. Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells [J]. Surgery, 1997; 121(1): 72-78.
24.	Rofe AM, Bourgeois CS, Coyle P. Beneficial effects of endotoxin treatment on metabolism in tumour-bearing rats [J]. Immunol Cell Biol, 1992; 70(Pt 1): 1-7.
25.	Jackson PG, Evans SR. Intraperitoneal macrophages and tu-mor immunity: A review [J]. J Surg Oncol, 2000; 75(2): 146-154.
26.	West MA, Hackam DJ, Baker J, et al. Mechanism of decreased in vitro murine macrophage cytokine release after exposure to carbon dioxide: relevance to laparoscopic surgery [J]. Ann Surg, 1997; 226(2): 179-190.
27.	罗华星，余佩武，王自强，等. 腹腔镜辅助下胃癌根治术对机体免疫功能的影响 [J]. 第三军医大学学报, 2005; 27(9): 910-912.
28.	Suematsu T, Hirabayashi Y, Shiraishi N, et al. Morphology of the murine peritoneum after pneumoperitoneum vs laparotomy [J]. Surg Endosc, 2001; 15(9): 954-958.
29.	刘彦，侯庆香. 二氧化碳气腹腹腔镜手术对人体腹膜形态学的影响 [J]. 中华医学杂志， 2006; 86(3): 164-166.
30.	郝迎学, 余佩武, 钱锋, 等. 腹腔镜胃癌根治术后腹腔游离癌细胞的变化及意义 [J]. 中华外科杂志, 2008; 46(23): 1748-1749.
31.	青廉，余佩武，王自强，等. 腹腔镜胃癌根治术后腹腔冲洗液CEA mRNA的变化和意义 [J]. 消化外科, 2006; 5(2): 102-104.
32.	Neuhaus SJ, Watson DI, Ellis T, et al. Influence of cytotoxic agents on intraperitoneal tumor implantation after laparoscopy [J]. Dis Colon Rectum, 1999; 42(1): 10-15.
33.	Peng Y, Zheng M, Feng B, et al. Hyperthermic CO2 pneumoperitoneum induces apoptosis in human colon cancer cells through Bax-associated mitochondrial pathway [J]. Oncol Rep, 2008; 19(1): 73-79.

1. Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer [J]. N Engl J Med, 2004; 350(20): 2050-2059.
2. Braga M, Frasson M, Vignali A, et al. Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival [J]. Dis Colon Rectum, 2005; 48(12): 2217-2223.
3. 郑民华，蔡景理，陆爱国，等. 腹腔镜手术治疗结直肠癌安全性的临床研究 [J]. 外科理论与实践, 2003; 8(5): 361-364.
4. 余佩武，钱锋，罗华星，等. 腹腔镜胃癌根治术的临床疗效 [J]. 中华消化外科杂志, 2008; 7(1): 38-40.
5. Memon MA, Khan S, Yunus RM, et al. Meta-analysis of laparoscopic and open distal gastrectomy for gastric carcinoma [J]. Surg Endosc, 2008; 22(8): 1781-1789.
6. Gutt CN, Kim ZG, Hollander D, et al. CO2 environment influences the growth of cultured human cancer cells dependent on insufflation pressure [J]. Surg Endosc, 2001; 15(3): 314-318.
7. Wittich P, Steyerberg EW, Simons SH, et al. Intraperitoneal tumor growth is influenced by pressure of carbon dioxide pneumoperitoneum [J]. Surg Endosc, 2000; 14(9): 817-819.
8. 石彦，郝迎学，雷晓，等. 模拟CO2气腹对人胃癌MKN-45细胞增殖和细胞周期的影响 [J]. 第三军医大学学报, 2007; 29(23): 2274-2276.
9. Hao YX, Zhong H, Zhang C, et al. Effects of simulated carbon dioxide and helium peumoperitoneum on proliferation and apoptosis of gastric cancer cells [J]. World J Gastroenterol, 2008; 14(14): 2241-2245.
10. Tomita H, Marcello PW, Milsom JW, et al. CO2 pneumoperitoneum does not enhance tumor growth and metastasis: study of a rat cecal wall inoculation model [J]. Dis Colon Rectum, 2001; 44(9): 1297-1301.
11. 郑民华，马君俊，冯波，等. 不同压强持续性CO2对结肠癌细胞侵袭转移的影响 [J]. 中华实验外科杂志, 2005; 22(10): 1164-1166.
12. 郝迎学，钟华，张超，等. 体外模拟气腹环境对胃癌细胞增殖凋亡的影响 [J]. 中国微创外科杂志, 2008; 8(6): 552-555.
13. 郝迎学，钟华，曾冬竹，等. 缺氧诱导因子1α对CO2气腹环境下人胃癌细胞凋亡的影响 [J]. 中华普通外科杂志， 2008; 43(6): 460-463.
14. Kim ZG, Mehl C, Lorenz M, et al. Impact of laparoscopic CO2-insufflation on tumor-associated molecules in cultured colorectal cancer cells [J]. Surg Endosc, 2002; 16(8): 1182-1186.
15. Paraskeva PA. Hypoxic pneumoperitoneum initiates the metastatic cascade in colon cancer cells [J]. Br J Surg, 2000; 87(suppl 1): 3.
16. 郑民华，马君俊，冯波，等. CO2气腹对结肠癌细胞粘附能力影响及其与粘附分子的关系 [J]. 中国实用外科杂志, 2005; 25(11): 668-670.
17. 郝迎学，钟华，曾冬竹，等. 不同压力二氧化碳气腹对胃癌细胞增殖运动的影响 [J]. 中华消化外科杂志, 2008; 7(1): 56-58.
18. 郝迎学，钟华，张超，等. 不同压力二氧化碳气腹对胃癌细胞迁移运动和细胞骨架的影响 [J]. 中华胃肠外科杂志, 2008; 11(5): 454-457.
19. 石彦，钱锋，郝迎学，等. 二氧化碳气腹对胃癌MKN-45细胞侵袭能力的影响 [J]. 中华消化外科杂志, 2007; 6(6): 449-451.
20. Wildbrett P, Oh A, Naundorf D, et al. Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function [J]. Surg Endosc, 2003; 17(1): 78-82.
21. Duerr FM, Twedt DC, Monnet E. Changes in pH of peritoneal fluid associated with carbon dioxide insufflation during laparoscopic surgery in dogs [J]. Am J Vet Res, 2008; 69(2): 298-301.
22. Volz J, Kster S, Spacek Z, et al. Characteristic alterations of the peritoneum after carbon dioxide pneumoperitoneum [J]. Surg Endosc, 1999; 13(6): 611-614.
23. Jacobi CA, Sabat R, Bhm B, et al. Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells [J]. Surgery, 1997; 121(1): 72-78.
24. Rofe AM, Bourgeois CS, Coyle P. Beneficial effects of endotoxin treatment on metabolism in tumour-bearing rats [J]. Immunol Cell Biol, 1992; 70(Pt 1): 1-7.
25. Jackson PG, Evans SR. Intraperitoneal macrophages and tu-mor immunity: A review [J]. J Surg Oncol, 2000; 75(2): 146-154.
26. West MA, Hackam DJ, Baker J, et al. Mechanism of decreased in vitro murine macrophage cytokine release after exposure to carbon dioxide: relevance to laparoscopic surgery [J]. Ann Surg, 1997; 226(2): 179-190.
27. 罗华星，余佩武，王自强，等. 腹腔镜辅助下胃癌根治术对机体免疫功能的影响 [J]. 第三军医大学学报, 2005; 27(9): 910-912.
28. Suematsu T, Hirabayashi Y, Shiraishi N, et al. Morphology of the murine peritoneum after pneumoperitoneum vs laparotomy [J]. Surg Endosc, 2001; 15(9): 954-958.
29. 刘彦，侯庆香. 二氧化碳气腹腹腔镜手术对人体腹膜形态学的影响 [J]. 中华医学杂志， 2006; 86(3): 164-166.
30. 郝迎学, 余佩武, 钱锋, 等. 腹腔镜胃癌根治术后腹腔游离癌细胞的变化及意义 [J]. 中华外科杂志, 2008; 46(23): 1748-1749.
31. 青廉，余佩武，王自强，等. 腹腔镜胃癌根治术后腹腔冲洗液CEA mRNA的变化和意义 [J]. 消化外科, 2006; 5(2): 102-104.
32. Neuhaus SJ, Watson DI, Ellis T, et al. Influence of cytotoxic agents on intraperitoneal tumor implantation after laparoscopy [J]. Dis Colon Rectum, 1999; 42(1): 10-15.
33. Peng Y, Zheng M, Feng B, et al. Hyperthermic CO2 pneumoperitoneum induces apoptosis in human colon cancer cells through Bax-associated mitochondrial pathway [J]. Oncol Rep, 2008; 19(1): 73-79.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Present Situation and Prospect of Influence of CO2 Pneumoperitoneum on Invasion and Metastasis of Gastrointestinal Neoplasm

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