povidone-iodine and Neoplasm-Metastasis

Topics: Carcinoma, Renal Cell; Cell Line, Tumor; Humans; Kidney Neoplasms; Neoplasm Metastasis; Neoplasm Recurrence, Local; Nephrons; Organ Sparing Treatments; Povidone-Iodine; Risk Factors

Recent experimental studies suggest that laparoscopic surgery for abdominal malignancy may be associated with increased tumor implantation. This study investigated the influence of cytotoxic agents (administered intraperitoneally or intramuscularly) on implantation of a tumor cell suspension after laparoscopic surgery in an experimental model.. Thirty-three Dark Agouti rats underwent laparoscopy with CO2 insufflation and instillation of a tumor cell suspension into the abdominal cavity. Rats were randomly allocated to one of the following study groups (9 rats in the control group, 6 rats in all other groups): 1) control (no intraperitoneal instillation); 2) intraperitoneal normal saline (0.9 percent); 3) intraperitoneal povidone-iodine (Betadine to normal saline 1:10 dilution); 4) intraperitoneal methotrexate (2 doses of 0.125 mg/kg body weight in normal saline administered 24 hours apart); 5) intramuscular injection of 2 doses of 0.125 mg/kg body weight administered 24 hours apart (no intraperitoneal agent). Rats were killed 7 days after the procedure, and the peritoneal cavity and port sites were examined for the presence of tumor.. A significant reduction in tumor implantation and port-site metastases was observed in all treatment groups (povidone-iodine and intramuscular and intraperitoneal methotrexate).. This study suggests that tumor implantation after laparoscopic surgery and port-site metastases might be prevented by the intraperitoneal or systemic administration of cytotoxic agents. Further studies are needed to determine whether these findings can be applied to clinical practice.

Topics: Animals; Antineoplastic Agents; Injections, Intramuscular; Injections, Intraperitoneal; Laparoscopy; Methotrexate; Neoplasm Metastasis; Neoplasm Seeding; Neoplasm Transplantation; Peritoneal Cavity; Povidone-Iodine; Random Allocation; Rats

Therapeutic strategies to prevent port site recurrences in laparoscopy surgery of malignancies have not been investigated until now.. The effects of taurolidine, heparin, and povidone iodine on the growth of rat and human colon adenocarcinoma as well as gallbladder carcinoma were investigated in vitro. Furthermore, cytokine release of growth-stimulating IL-1beta by peritoneal macrophages was measured after incubation with carbon dioxide and additional incubation with the different agents. In the third experiment, prevention of intra- and extraperitoneal metastases by intraperitoneal instillation of the different agents during laparoscopy was investigated in a colon carcinoma model in the rat. Tumor cells were administered intraperitoneally in 100 rats, and pneumoperitoneum (8 mm Hg) was established over 30 min with carbon dioxide. Rats received either tumor cells, cells + heparin, cells + povidone iodine, cells + taurolidine, or cells + taurolidine + heparin.. In vitro, tumor cell growth decreased after incubation with taurolidine, taurolidine/heparin, and povidone iodine. Cytokine release was stimulated by incubation with carbon dioxide and could only be suppressed by incubation with taurolidine in vitro. In vivo, intraperitoneal tumor weight was lower in rats receiving heparin (251 +/- 153 mg) and povidone iodine (134 +/- 117 mg) compared to the control group (541 +/- 291 mg), but even less when taurolidine (79 +/- 82 mg) or taurolidine/heparin (18.3 +/- 30 mg) were instilled.. Heparin slightly inhibits intraperitoneal tumor growth in vivo, while povidone iodine and taurolidine cause a significant decrease in tumor cell growth in vitro as well as intraperitoneal tumor growth in vivo. Cytokine release of peritoneal macrophages is only suppressed by taurolidine. Total tumor take and trocar metastases are only suppressed by taurolidine and taurolidine/heparin.

Topics: Adenocarcinoma; Animals; Anti-Infective Agents, Local; Carbon Dioxide; Colonic Neoplasms; Gallbladder Neoplasms; Heparin; Humans; Interleukin-1; Laparoscopy; Macrophages, Peritoneal; Male; Neoplasm Metastasis; Neoplasm Seeding; Peritoneal Cavity; Povidone-Iodine; Rats; Rats, Inbred Strains; Taurine; Thiadiazines; Tumor Cells, Cultured

Forty-eight of 72 surgeons canvassed in the South West of England (67%) routinely use an intraluminal cytotoxic agent to prevent suture-line recurrence following partial resection of the large bowel for cancer. The most popular agents are chlorhexidine-cetrimide preparations (n = 14), mercuric perchloride (12), povidone-iodine (7) and water (12); noxythiolin, sodium hypochlorite and silver nitrate are used occasionally. The mean duration of treatment is 2 minutes. When assayed for cytotoxity against tumour cells freshly prepared from human colorectal carcinomas (n = 10), both chlorhexidine-cetrimide and povidone-iodine were rapidly lethal at a wide range of concentrations (5-100%). Mercuric perchloride (0.2%) was similarly effective, but up to 20% of tumour cells remained viable after exposure to noxythiolin and nearly 30% with water alone. Chlorhexidine-cetrimide and povidone-iodine are the agents of choice to kill malignant cells exfoliated into the colorectal lumen.

Topics: Anti-Infective Agents, Local; Cell Survival; Cetrimonium; Cetrimonium Compounds; Chlorhexidine; Colonic Neoplasms; Humans; Mercuric Chloride; Mercury; Neoplasm Metastasis; Neoplasm Recurrence, Local; Noxythiolin; Postoperative Complications; Povidone-Iodine; Rectal Neoplasms; Water