Background Surgical trauma may be associated with
enhanced tumor growth and establishment. The authors
studied the effect of carbon dioxide (CO2) pneumoperitoneum
versus laparotomy on tumor necrosis factor-a (TNFa),
migration inhibitory factor (MIF) expression, and nuclear
factor kappa B (NFjB) activity in human gastric cancer.
Methods Nude mice were inoculated intraperitoneally
with human gastric cancer cells (MKN45). Then laparotomy,
CO2 pneumoperitoneum, and anesthesia alone were
performed randomly. Tumor growth and associated TNFa
and MIF expression and NFjB activity were determined.
Results Total tumor weight, especially at the anterior
abdominal wall, was higher after laparotomy than after
CO2 pneumoperitoneum (p.05). The mRNA expression
of TNFa was higher 24 and 48 h after laparotomy than
after CO2 pneumoperitoneum (p.05 and p.01,
respectively). At all the examined time points, MIF mRNA
expression also was higher after laparotomy than after CO2
pneumoperitoneum (p.05 until 1 week or p.01 at
2 weeks). The NFkB protein was more activated after
laparotomy than after CO2 pneumoperitoneum 6 h subsequent
to surgical procedures.
Conclusion After CO2 pneumoperitoneum, tumors have
less TNFa and MIF expression and less NFjB activity than after laparotomy. This may be associated with less tumor
growth, supporting minimal invasive techniques in gastrointestinal oncologic surgery.