Laparoscopic Port-Site Metastasis in Urologic Surgery

Abstract

Port-site metastasis has been an increasing concern with the spread of laparoscopy in managing urologic malignancies. The purpose of this study was to provide a current review of port-site metastases reported in the urologic oncology literature, as well as etiologic factors and preventative measures. A comprehensive Medline search (up to September 2007; subject headings: "neoplasm seeding," "laparoscopy," "urologic neoplasms") of all case reports and series related to laparoscopic urology surgery for malignant disease was performed. The references for each of these case reports and series were also reviewed for any additional reports of port-site metastases. Only 28 cases of port-site metastases involving urologic malignancies have been reported, with laparoscopic procedures involving upper tract transitional cell carcinoma comprising the majority (11/28 or 39%) of these. Recent reports involving renal cell carcinoma, prostatic carcinoma, and bladder cancer have been published as well. The incidence of port-site metastases is comparable with that seen following open surgery. The etiology is likely multifactorial, but adhering to proper surgical technique is the most effective preventative strategy.