ArticleAnnals of surgical oncology2015
Peritoneal Tumorigenesis and Inflammation are Ameliorated by Humidified-Warm Carbon Dioxide Insufflation in the Mouse.
Article in Annals of surgical oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Comparison of low versus high (standard) intraabdominal pressure during laparoscopic colorectal surgery: systematic review and meta-analysis.International journal of colorectal disease · 2024Pooled it
- Perioperative NSAIDs and Long-Term Outcomes After cancer Surgery: a Systematic Review and Meta-analysis.Current oncology reports · 2021Pooled it
- Warmed, humidified COAsian journal of endoscopic surgery · 2017Pooled it
- Effect of controlled hyperventilation on post-laparoscopic cholecystectomy shoulder pain: a prospective randomized controlled trial.Langenbeck's archives of surgery · 2025Trial
- Trial
- Article
- Organotropic metastasis in colorectal cancer: integrating molecular pathways with therapeutic opportunities.Frontiers in immunology · 2025Review
- Minimally Invasive Surgery: Is It a Risk Factor for Postoperative Peritoneal Metastasis in pT4 Colon Cancer?Annals of surgical oncology · 2025Article
- Clinical Outcomes and Prognostic Factors for R0 Resected Colorectal Cancer with Synchronous Peritoneal Metastasis: A Retrospective Study.Journal of the anus, rectum and colon · 2024Article
- ASO Author Reflections: Humidification of Carbon Dioxide for Insufflation Offers Promise in Reducing Inflammation and Peritoneal Trauma During and Post Colorectal Cancer Surgery.Annals of surgical oncology · 2023Article
- Harnessing interventions during the immediate perioperative period to improve the long-term survival of patients following radical gastrectomy.World journal of gastrointestinal surgery · 2023Review
- Successful resection of port site recurrence of pancreatic ductal adenocarcinoma after laparoscopic distal pancreatectomy.Surgical case reports · 2023Article
- The Impact of Perioperative Events on Cancer Recurrence and Metastasis in Patients after Radical Gastrectomy: A Review.Cancers · 2022Review
- Systemic immune inflammation index and peripheral blood carbon dioxide concentration at admission predict poor prognosis in patients with severe traumatic brain injury.Frontiers in immunology · 2022Article
- Primary and metastatic peritoneal surface malignancies.Nature reviews. Disease primers · 2021Review
- Modes of carbon dioxide delivery during laparoscopy generate distinct differences in peritoneal damage and hypoxia in a porcine model.Surgical endoscopy · 2020Article
- Surgical complications in colorectal cancer patients.Annals of medicine and surgery (2012) · 2020Review
- "Peritoneal failure": A new concept to explain negative results of randomized trials evaluating intraperitoneal therapies.Pleura and peritoneum · 2020Article
- Modeling open surgery in mice to explore peritoneal damage, carbon dioxide humidification and desmoidogenesis.Pleura and peritoneum · 2019Article
- Perioperative events influence cancer recurrence risk after surgery.Nature reviews. Clinical oncology · 2018Review
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConventional laparoscopic surgery uses CO2 that is dry and cold, which can damage peritoneal surfaces. It is speculated that disseminated cancer cells may adhere to such damaged peritoneum and metastasize. We hypothesized that insufflation using humidified-warm CO2, which has been shown to reduce mesothelial damage, will also ameliorate peritoneal inflammation and tumor cell implantation compared to conventional dry-cold CO2.
methodsLaparoscopic insufflation was modeled in mice along with anesthesia and ventilation. Entry and exit ports were introduced to maintain insufflation using dry-cold or humidified-warm CO2 with a constant flow and pressure for 1 h; then 1000 or 1 million fluorescent-tagged murine colorectal cancer cells (CT26) were delivered into the peritoneal cavity. The peritoneum was collected at intervals up to 10 days after the procedure to measure inflammation, mesothelial damage, and tumor burden using fluorescent detection, immunohistochemistry, and scanning electron microscopy.
resultsRapid temperature control was achieved only in the humidified-warm group. Port-site tumors were present in all mice. At 10 days, significantly fewer tumors on the peritoneum were counted in mice insufflated with humidified-warm compared to dry-cold CO2 (p < 0.03). The inflammatory marker COX-2 was significantly increased in the dry-cold compared to the humidified-warm cohort (p < 0.01), while VEGFA expression was suppressed only in the humidified-warm cohort. Significantly less mesothelial damage and tumor cell implantation was evident from 2 h after the procedure in the humidified-warm cohort.
conclusionsMesothelial cell damage and inflammation are reduced by using humidified-warm CO2 for laparoscopic oncologic surgery and may translate to reduce patients' risk of developing peritoneal metastasis.
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