Port site recurrences after laparoscopic and thoracoscopic procedures in malignancy.

PURPOSE AND METHODS: A review of the literature was performed to determine the number of cases of port site recurrences (PSR) after laparoscopy or thoracoscopy. CANCERLINE and MEDLINE were searched, as were citings from retrieved and related papers. RESULTS: There have been 35 reported cases of PSR after laparoscopic colectomy for colorectal carcinoma, and 23 cases after thoracoscopic procedures for lung neoplasms. All of these have been reported since 1993. Since 1991, 12 cases have been described after laparoscopic cholecystectomy of unsuspected gallbladder carcinoma, and another case after biopsy of a known gallbladder carcinoma. Ten cases of PSR have been reported after laparoscopic procedures for ovarian lesions, often in the presence of peritoneal seeding at diagnosis. Other rare PSRs have been documented after several procedures in various malignancies. CONCLUSION: Enrollment of patients onto the ongoing intergroup study evaluating open versus laparoscopic resection of colon cancer should be encouraged. Until valid prospective data on PSR frequency are available, laparoscopic or thoracoscopic resection of malignancy off-protocol should be undertaken with circumspection.

Prevention of distal limb ischemia during cardiopulmonary support via femoral cannulation.

The indications for prolonged cardiopulmonary support or extracorporeal membrane oxygenation are expanding. A potential serious complication of these techniques is distal limb ischemia. Techniques have been developed to provide the distal limb with blood flow. Unfortunately, specialized skills and materials are required. We describe a simple method of providing distal limb perfusion using ordinary pressure tubing and a standard cordis catheter. This technique is capable of reproducing normal superficial femoral artery blood flow.