Laparotomy Scar Research Articles

Typology of Terminal Colon at the Chu of Point G in Bamako

Purpose: To describe the morphometric types of the terminal colon. Patients and Methods: This was an anatomical study by laparotomy for the terminal colon on 7 living subjects and by anatomical dissection on 8 fresh cadaveric subjects in the department of surgery B of the CHU of Point G and in the anatomy laboratory of the faculties of medicine of odonto-stomatology (FMOS) and pharmacy (FAPH) of Bamako from January 1, 2018 to December 31, 2019 or 2 years. Patients without a mass on the terminal recto-colonic junction or volvulus of the terminal colon or abdominopelvic mass on the terminal colon and fresh cadavers declared unknown without a laparotomy scar coming from Bamako University Hospitals or Reference Centers (CS Réf) were included in this study. Results: We investigated 15 cases, including 7 live cases and 8 cadavers. Males accounted for 60% (n=9) and females 40% (n=6), i.e. a sex ratio of 1.5. Mean age was 47.14 ±15.57 years. The mean length of the terminal colon was 41.79 cm±13.37. The mean length of the terminal mesocolon was 11.18 cm. The maximum height of the terminal mesocolon averaged 10.70 cm ± 3.61 cm. There were 46.72% (n=7) medium-form cases, 33.30% (n=5) short-form cases and 19.98% (n=3) long-form cases. Conclusion: The terminal colon can be short, medium or long, depending on its length and the height of its meso.

Subcutaneous endoscopic surgery for plicating divarication of recti and epigastric hernia repair in a child.

Epigastric hernia with divarication of recti is uncommon in children, and the aetiology remains incompletely understood - as does the optimal management strategy - whether to repair epigastric hernia alone or both defects. We present an innovative technique utilising subcutaneous endoscopic surgery to address both epigastric hernia and divarication in children. Our approach yields excellent cosmetic outcomes, avoids the need for a larger laparotomy scar and mitigates the risks associated with the transperitoneal laparoscopic approach. It is a viable option with all the advantages of minimally invasive surgery for repairing epigastric hernia and divarication of recti in symptomatic cases, particularly when the aetiology is uncertain and multiple defects are anticipated. Its use may be extrapolated to isolated diastasis recti as working in subcutaneous space involves lesser risk with excellent cosmesis.

Ventral incisional hernia and double parastomal hernia repair with retromuscular biosynthetic mesh using the SMART technique (Stapled Mesh Stoma Reinforcement Technique) after cancer-related pelvic exenteration

We report on the case of a 64-year-old man who underwent the SMART surgical technique using retromuscular biosynthetic mesh for parastomal hernia. This patient had a terminal colostomy and Bricker ileal conduit following pelvic exenteration for locally advanced low rectal adenocarcinoma. Since then, he had undergone a first median incisional hernia repair using intraperitoneal biosynthetic mesh, followed a year later by the onset of a symptomatic parastomal hernia at the stoma sites and next to the median laparotomy scar. It was thus decided to perform a double parastomal hernia repair using the SMART technique with retromuscular biosynthetic mesh.

P-091 Primary intestinal lymphoma associated with enteric fistula to an intraperitoneal mesh: what came first?

Abstract Aim To present the possible association between the use of intraperitoneal mesh and the appearance of primary intestinal lymphoma. Material and Methods We present the case of a 67-year-old woman with a history of multiple abdominal surgeries (appendectomy, Hartmann's procedure for perforated diverticulitis and reoperation due to hemoperitoneum). Ventral hernia repair was performed placing intraperitoneal composite mesh in 2013. Eight years later, the patient consulted with abdominal pain and bulging located on previous laparotomy scar. Abdominal CT was carried out, demonstrating an intestinal fistula from the jejunum to the mesh with an adjacent 5 cm intraabdominal abscess. Results Elective surgery was decided on. An enteric fistula from the jejunum to the previous mesh was observed, as well as pathologic lymph nodes adhered to the mesh. Intestinal resection was performed prior mesh excision. Histopathological analysis was compatible with extranodal B-cell lymphoma of the marginal zone. Conclusions Enteric fistula rate associated with the use of intraperitoneal mesh is 0.3–4%. There are no published cases of intestinal lymphoma correlated with the use of intraperitoneal mesh. Primary intestinal lymphoma constitutes 1–4% of bowel malignancies. The most common type is extranodal marginal zone MALT B lymphoma. Typical locations are: gastric (50%), small bowel (33–40%) and colon (10–15%). Situations of chronic inflammation such as celiac disease, inflammatory bowel disease, Campylobacter jejuni infection or inflammatory reactions are known to cause this entity. In this particular case, an excessive inflammatory response to an intraperitoneal mesh resulting in enteric fistula could be the source of malignancy, or vice versa.

Heterotopic mesenteric ossification

Heterotopic calcification has been previously noted in healed laparotomy scars, within the peritoneum and is extremely rare. Heterotopic mesenteric ossification (HMO) is a rare disease that refers to intra-abdominal calcification of unknown aetiology, involving the mesentery. They can lead to serious complications such as enterocutaneous fistulations, intestinal obstruction, perforation and recurrent sepsis. We report a case of 26-year-old who presented with recurrent intra-abdominal collection, following an operation for blunt trauma abdomen, and was found to have HMO. He underwent exploratory laparotomy, and multiple intrabdominal new bone formations were observed, especially over the small bowel mesentery.

Port-Site Metastasis (PSM): Definition, clinical contexts and possible preventive actions to reduce risk

The "port-site metastasis" represents a tumor recurrence that develops in the abdominal wall within the scar tissue of the insertion site of one or more trocars, after laparoscopic surgery, not associated with peritoneal carcinomatosis. This last aspect is central because in the literature some isolated cases are reported, but most cases are associated with peritoneal carcinomatosis. The first case in the literature dates back to 1978 and in the literature, the incidence varies from 1% to 21%, although most published research reports a very small number of patients. Currently, the incidence in a specialized cancer center is consistent with the incidence of recurrence on a laparotomy scar. Possible mechanisms for cell implantation at the port site are direct implantation into the wound during forced, unprotected tissue retrieval or from contaminated instruments during tumor dissection; the effect of gas turbulence in lengthy laparoscopic procedures, and embolization of exfoliated cells during tumor dissection or hematogenous spread. Probably, however, the triggering mechanism is necessarily multifactorial. To date, the only significant prognostic factor in patients diagnosed with port-site metastasis is the interval between laparoscopy and the diagnosis of the port site: in fact, patients who develop the port site within 7 months after surgery have a generally worse prognosis, as well as port-site metastasis are more frequent in advanced cancers and the presence of ascites. To reduce the risk, the following measures are proposed in the literature: 1) Select the patient who does not have a metastatic oncologic condition or friable cancerous masses or lymph node spread or attached external or intracystic vegetations, preferring well-localized, benign or low-malignant or otherwise intact tumors; 2) Use wound protectors and use of protective bags (or endo bag) for tissue retrieval; 3) Peritoneal washing with heparin, to prevent free cell adhesion, or washing with cytocidal solutions. Evaluate the utility of using Povidone-iodine, Taurolidine (which has anti-adhesion activity and decreases proangiogenic factors), and chemotherapy products; 4) Avoid removing pneumoperitoneum with trocars in place; 5) Avoiding direct contact between the solid tumor and the port site; 6) Prefer laparoscopy to laparotomy, if possible; 7) Avoid the use of gas or direct CO2 insufflation, although in literature the point is controversial and deserves more attention and study, as the initial hypothesis that CO2 increased the invasion capacity of tumor cells (in vitro and in vivo) has been refuted several times. Insufflation of hyperthermic CO2 and humidified CO2 leads to a better outcome in patients with a malignant tumor who undergo a laparoscopic procedure compared with normal CO2 pneumoperitoneum; 8) Comply with surgical protocols and techniques by updating one's surgical skills, as it has been demonstrated, as already reported here, the presence of cancerous cells on instruments, washing systems and trocars (in particular, on the trocars of the first operator). Suturing all layers of the abdominal wall decreases the risk of the port site; 9) Avoid excessive manipulation of the tumor mass during the surgical/operative procedure.

A rare case of D2 perforation in blunt injury abdomen

A 47-year-old female brought by attenders to casualty with alleged history of accidental injury, struck against iron rail in bus 1 day before sustained injury in abdomen. Presented with complaints of abdominal pain, vomiting for 2 days. Previous history of duodenal ulcer - Gastric outlet Obstruction & undergone bilateral truncal vagotomy with posterior Gastrojejunostomy 1year before. She was dehydrated, hemodynamically unstable bp not recordable, pulse feeble, with upper midline healed laparotomy scar in abdomen and tenderness in upper abdomen, diffuse swelling progressively increasing in size noted in epigastric region, guarding present. Patient was resuscitated. Supine Xray abdomen showed dilated bowel loops. CT abdomen showed pneumoperitoneum, free fluid in pelvis, no solid organ injury. Patient was taken for emergency laprotomy. Intraoperatively Omental adhesions to previous scar and about 300ml of turbid fluid noted, Status postoperative posterior Gastrojejunostomy. Colon-free from injuries. Diffuse saponification noted in omentum. Bile staining present. D2 perforation of size 2×2cm noted in anterolateral aspect. Pyloric exclusion, primary closure of duodenal injury and Tube duodenostomy done. Ryles tube passed through distal limb of GJ for feeding purposes postoperatively.

Short Outcome Evaluation of Laparoscopic Ventral Hernia Repair Ahmed Saleh Mostafa Baghdady, Hussein Ali Mostafa,

Background: Ventral hernia is defined as primary anterior abdominal wall and incision hernia not including the groin. There are number of risk factors that lead to hernia to occur; like wound infection, morbid obesity, immunosuppression, previous operations, prostatism, and surgery for aneurysmal disease. Hernia defect can form within first 5 years of surgery but can occur late as well. Objective: To evaluate the short-term outcome of laparoscopic ventral hernia repair as regard feasibility and safety, operative time and types of hernias. Patients and methods: This study is a prospective nonrandomized study. It included forty out of sixty consecutive patients admitted at the Department of General Surgery, Aswan University, Aswan Egypt, with diagnosis of ventral and or incisional hernia in the period from July 2016 to December 2019. Results: This study included 22 male and 18 female patients. 11 male patients had incisional hernia and 11 patients with ventral hernia. Types of hernias: Twenty-one cases had virgin abdomen with no previous surgeries while 19 cases had previous surgery done before; described as follows: midline laparotomy scar (11), caesarian section scar (5), port site scar (2) and appendectomy scar (1). Operative time: In first 20 operated cases the mean operative time was 120 min while in the last 20 cases with increasing learning curve the operative time starts to reduce markedly, and the mean time became 70 min. Conclusion: Laparoscopic ventral hernia repair is an appropriate, safe and feasible approach for ventral hernia repair with short operative time.

Therapeutic Targeting of Neutrophil Extracellular Traps Improves Primary and Secondary Intention Wound Healing in Mice.

BackgroundNeutrophils are the first responders in wound healing after injury that mediate pro- and anti-inflammatory activities i.a. through the formation of extracellular traps (NETs). However, excessive NETs presence in wound tissue can cause local hyperinflammation and -coagulation resulting in delayed wound healing. To improve wound healing, we aimed to examine the role of NETs and DNase1 on primary and secondary wound healing.MethodsThe study included 93 C57BL/6 mice, with 3 different genotypes: wildtype, Pad4-, and DNase1-Knockout (KO). Pad4-KO mice show limited NETs formation, while DNase1-KO mice cannot disintegrate them. All 3 genotypes were included in (1) a laparotomy group and (2) a thermal injury group. Animals in both groups either received DNase1 or a vehicle i.p. post wound induction and wound assessment and euthanasia were conducted. Laparotomy and burn scars were assessed using the stony brook scar evaluation scale and modified Yeong scale respectively. Tissue was analyzed histologically using H&E staining. Ly6g, Collagen I and III, SMA, and Fibrinogen were visualized and neutrophils activation (NE, MPO) and NETs (H3cit) formation assessed.ResultsAll animals survived with no complications. DNase1 treatment led to a significantly improved scar appearance in both groups, which was also seen in Pad4-KO mice. In the laparotomy group DNase1 improved collagen deposition and fibrin concentration was significantly reduced by DNase1 treatment. Markers of neutrophil activation were significantly reduced in the treatment and Pad4-KO group. In the thermal injury group wound closure time was significantly reduced after DNase1 treatment and in the Pad4-KO group. Even though inflammation remained high in the thermal injury model over time, neutrophil activation and NETs formation were significantly reduced by DNase1 treatment compared to controls.DiscussionPrimary and secondary intention wound healing is improved by targeting NETs through DNase1 treatment or genetic KO, as assessed by wound closure time and scar appearances. Additionally, wound stability was not affected by DNASE treatment. The results suggest that overall wound healing is accelerated and DNase1 appears to be a promising option to reduce scar formation; which should be evaluated in humans.

Does the appearance of the cutaneous scar after cesarean section reflect the residual myometrial thickness?

PurposeThe aim of this study is to utilize the Manchester scar scale (MSS) and ultrasound in investigating the association between uterine wall defects and cutaneous scar characteristics after cesarean section (CS).MethodsThis is a prospective cohort study. The degree of myometrial loss was quantified by calculating a residual myometrial thickness (RMT) ratio as a percentage of RMT to the pre-cesarean anterior uterine wall thickness. Cutaneous scar assessment was performed according to the MSS. Spearman’s correlation and the Kruskal–Wallis test with a cut-off value of p < 0.05 were used for statistical analysis.ResultsTwo hundred forty seven women, of which 2.4% had an Asian, 3.6% an Afro-American, 82% a Caucasian and 12% a Mediterranean background, were recruited. The RMT ratio ranged between 11.9 and 100% with a median of 55.8% and an average of 56%. MSS scores ranged from 4 to 13 with a median of 5 and an average of 6. Spearman’s correlation between MSS and RMT ratio show a rho of − 0.01 with a p value of 0.8. The correlation between MSS and RMT ratio within the four ethnical groups showed a p value between 0.3 and 0.8 and a rho between 0.8 and − 0.8. The Kruskal–Wallis test showed an eta2 of 0.13 and a p value of 0.0002 for the effect of ethnicity on MSS and an eta2 of 0.009 and a p value of 0.68 for the effect of ethnicity on the RMT ratio.ConclusionCS laparotomy scars heal differently between ethnical groups, but generally with satisfying results. Ethnicity does not affect myometrial healing and scar appearance does not reflect myometrial healing after CS. Thus, separate uterine sonographic assessment is recommended.

Occurrence of seeding metastases in resectable perihilar cholangiocarcinoma and the role of low-dose radiotherapy to prevent this.

BACKGROUNDPreoperative biliary drainage in patients with presumed resectable perihilar cholangiocarcinoma (PHC) is hypothesized to promote the occurrence of seeding metastases. Seeding metastases can occur at the surgical scars or at the site of postoperative drains, and in case of percutaneous biliary drainage, at the catheter port-site. To prevent seeding metastases after resection, we routinely treated PHC patients with preoperative radiotherapy (RT) for over 25 years until January 2018.AIMTo investigate the incidence of seeding metastases following resection of PHC.METHODSAll patients who underwent resection for pathology proven PHC between January 2000 and March 2019 were included in this retrospective study. Between 2000-January 2018, patients received preoperative RT (3 × 3.5 Gray). RT was omitted in patients treated after January 2018.RESULTSA total of 171 patients underwent resection for PHC between January 2000 and March 2019. Of 171 patients undergoing resection, 111 patients (65%) were treated with preoperative RT. Intraoperative bile cytology showed no difference in the presence of viable tumor cells in bile of patients undergoing preoperative RT or not. Overall, two patients (1.2%) with seeding metastases were identified, both in the laparotomy scar and both after preoperative RT (one patient with endoscopic and the other with percutaneous and endoscopic biliary drainage).CONCLUSIONThe incidence of seeding metastases in patients with resected PHC in our series was low (1.2%). This low incidence and the inability of providing evidence that preoperative low-dose RT prevents seeding metastases, has led us to discontinue preoperative RT in patients with resectable PHC in our center.

Transumblical versus Infraumblical pneumoperitoneum: A comparative study.

Objectives: In Laparoscopic surgery placement of primary port is an important step and is often associated with complications. Our objective is to compare the merits and demerits like safety, efficacy of the site, time of entry of the port, per-operative and post-operative complications of infrumbilical (IU) with transumbilical (TU) approach for placement of this port. So on the basis of best clinical evidence get a clinical direction for a better site for placement of primary port. Study Design: A prospective randomized controlled trial of 238 patients. Setting: Surgical unit II of DHQ Hospital/ Sargodha Medical College (University of Sargodha) Sargodha. Period: June 2015 to December 2017. Material &amp; Methods: Patients aged 16-70 years, fit for surgery, under general anesthesia were included in this study after informed consent. Patients who were unfit for general anaesthesia, who were Imuno-compromised, diabetics, CLD, with ascites, patients with suspected malignancy, with previous surgery in the umbilical region like midline laparotomy scar, previous hernia repair in this region were excluded from this study. Permission was sought from and granted by institutional ethical committee. Results: A total number of 238 patients were included. Group A (Trans-Umbilical) and Group B (Infra-Umbilical) contained 119 cases each. There were 147 female and 91 male. (M: F ratio of 1: 1.615). Conclusion: Based on results from this study and previous literature, it may be concluded that Transumbilical (TU) placement of primary port for creation of pneumoperitoneum is superior to infrumbilical (IU) approach.

Heterotopic ossification at the level of a laparotomy scar

We report the cases of two patients referred to our radiology department for a thoracoabdominal computed tomography (CT) scan as part of their routine postoperative follow-up as both the patients were asymptomatic. The first patient is a 60-year-old female who underwent a laparotomy for gastric gastrointestinal stromal tumor (GIST) 11 months ago, and checked into our radiology department for a thoracoabdominal CT scan as part of her follow-up assessment. The patient had no complaints. The CT scan revealed a 7 cm long vertical linear calcified lesion in the anterior abdominal wall at the anterior aspect of the xiphoid process corresponding to a heterotopic ossification of the laparotomy scar (Figure 1). The second patient is a 33-year-old male who had undergone laparotomy for total gastrectomy one month earlier due to a gastric adenocarcinoma. The patient was received in our department for his first check-up after surgery and concomitant radiochemotherapy. Furthermore, the patient presented no complaints. The thoracoabdominal CT scan performed revealed a vertical calcified lesion at the level of the laparotomy scar extending about 11 cm from the xiphoid region to about 5 cm above the umbilicus, also corresponding to a heterotopic ossification of the laparotomy scar (Figure 2).

Detection of NDM-19, a novel variant of the New Delhi metallo-β-lactamase with increased carbapenemase activity under zinc-limited conditions, in Switzerland

A novel New Delhi metallo-β-lactamase (NDM) variant, NDM-19, was identified in a carbapenem-resistant E. coli strain isolated from a subcutaneous infection of a laparotomy scar from an Egyptian patient in a Swiss hospital. NDM-19 is a derivative of NDM-7, from which it differs by a single amino acid substitution (Ala233Val). Under zinc-limiting growth conditions, E. coli DH5α transformants producing NDM-19 displayed reduced susceptibility towards expanded-spectrum cephalosporins and carbapenems as compared to transformants producing NDM-1 or NDM-7.

The Many Guises of Endometriosis: Giant Abdominal Wall Endometriosis Masquerading as An Incisional Hernia.

Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterine cavity. Although it is a leading cause of chronic pelvic pain and infertility, its clinical presentation can vary, resulting in diagnostic and therapeutic challenges. Extrapelvic endometriosis is particularly difficult to diagnose owing to its ability to mimic other conditions. Endometrial tissue in a surgical scar is uncommon and often misdiagnosed as a granuloma, abscess, or malignancy. Cyclical hemorrhagic ascites due to peritoneal endometriosis is exceptionally rare. We report the case of a pre-menopausal, nulliparous 44-year-old woman who presented with ascites and a large abdominal mass that arose from the site of a lower midline laparotomy scar. Five years previously, she had undergone open myomectomy for uterine fibroids. Soon after her initial operation she developed abdominal ascites, which necessitated percutaneous drainage on multiple occasions. We performed a laparotomy with excision of the abdominal wall mass through an inverted T incision. The extra-abdominal mass consisted of mixed cystic and solid components, and weighed 1.52 kg. It communicated with the abdominopelvic cavity through a 2 cm defect in the linea alba. The abdomen contained a large amount of odourless, brown fluid which drained into the mass. There was a large capsule that covered the small and large bowel, liver, gallbladder, and stomach. Final histology reported a 28×19×5 cm mass of endometrial tissue with no evidence of malignant transformation. The patient recovered well post-operatively and has remained asymptomatic. Our case illustrates that, despite being a common disease, endometriosis can masquerade as several other conditions and be missed or diagnosed late. Delay in diagnosis will not only prolong symptoms but can also compromise reproductive lifespan. It is therefore paramount that endometriosis is to be considered early in the management of premenopausal women who present with an irregular pelvic mass or hemorrhagic ascites.

Donor mesenchymal stem cells home to maternal wounds after transamniotic stem cell therapy (TRASCET) in a rodent model

PurposeTransamniotic stem cell therapy (TRASCET) with amniotic fluid-derived MSCs (afMSCs) has emerged experimentally as a practical treatment strategy for congenital anomalies. In this study, we sought to determine whether afMSCs migrate to the mother following TRASCET. MethodsPregnant rat dams were divided into three groups. Two groups received volume-matched injections into all amniotic cavities of either a suspension of afMSCs labeled with a luciferase reporter gene or the luciferase protein alone. In a third group, a suspension of labeled cells was aliquoted onto the serosal surface of the uterus. Maternal samples from the laparotomy scar (fascia and skin separately), bone marrow, and peripheral blood were procured, along with placenta and umbilical cord. Specimens were screened for luminescence via microplate luminometry. ResultsLuminescence was detected in 60% (9/15) of the fascial scars from the group receiving intraamniotic injection of afMSCs, but in none of the other groups (P<0.001). There was a direct correlation between the presence of donor cells in the placenta and their presence in maternal fascia (Wald test=10.2; P=0.001). ConclusionsAmniotic mesenchymal stem cells migrate to maternal sites of injury after intraamniotic injection. Maternal homing of donor cells must be considered in the setting of transamniotic stem cell therapy. Level of evidenceN/A (animal and laboratory study).

Herniated gravid uterus through an infra-umbilical laparotomy scar: a case report

Herniation of a gravid uterus through the abdominal wall is a rare and potentially serious condition due to its antecedent complications. Management is determined by gestational age. Simultaneous hernioplasty with cesarean section is considered safe. Clinical awareness of this complication will prevent delay in its diagnosis and treatment. Delay in recognition of this condition can lead to incarceration and subsequent strangulation of the gravid uterus. Strangulation at or near term appears to be a genuine indication for early hospitalization and elective cesarean section, possibly combined with hernia repair. Here we report the case of a middle aged woman who presented with abdominal pain at 28 weeks of gestation with an unusual bulge of her abdomen. The lower abdominal bulge turned out to be her gravid uterus herniated through the anterior abdominal wall. Cesarean delivery with herniorrhaphy was done for the large abdominal defect.

Heterotopic Ossification of Laparotomy Scars in Nonhuman Primate

Heterotopic Ossification of Laparotomy Scars in Nonhuman Primate

Endometrioma of the Abdominal Wall after Caesarean Section

Background: Endometrial cell implantation after abdominal surgery, mainly after caesarean section, may result in formation of endometrioma, which is usually described to be of various sizes, and adjacent to the surgical scar. Case: A 36-year old woman complaining of a mass of the abdominal wall with pain during the menstrual period, with a caesarean section 5 years earlier, presented a rounded tumour not contiguous to the Pfannenstiel’s laparotomy scar, of hard consistence, fixed and adherent to the deep abdominal wall structures, located on the left paramedian epigastric region. Magnetic Resonance imaging showed the nodule, involving the deep layers of the abdominal wall and the distance from the laparotomic scar. Surgical removal was performed with wide excision of the lesion, causing a large wall defect. After histological confirmation (endometriosis) by frozen section, reconstruction of the abdominal wall required prolene mesh grafting. After twelve months the patient is healthy. Conclusion: When abdominal wall endometrioma is located distant from the scar, perhaps more frequently after Pfannenstiel’s laparotomic incision, the differential diagnosis may be more difficult and MRI can help differentiating many of these lesions, and histological confirmation should be obtained intraoperatively, by frozen section, to allow an oncological resection if required.

GROWTH FACTORS AND COX2 IN WOUND HEALING: AN EXPERIMENTAL STUDY WITH EHRLICH TUMORS.

ABSTRACTBackground: Healing is an innate biological phenomenon, and carcinogenesis acquired, but with common humoral and cellular elements. Carcinogenesis interferes negatively in healing. Aim: To evaluate the histological changes in laparotomy scars of healthy Balb/c mice and with an Ehrlich tumor in its various forms of presentation. Methods: Fifty-four mice were divided into three groups of 18 animals. First group was the control; the second had Ehrlich tumor with ascites; and the third had the subcutaneous form of this tumor. Seven days after tumor inoculation, all 54 mice were submitted to laparotomy. All of the animals in the experiment were operated on again on 7th day after surgery, with resection of the scar and subsequent euthanasia of the animal. The scars were sent for histological assessment using immunohistochemical techniques to evaluate Cox-2 (cyclooxygenase 2), VEGF (vascular endothelial growth factor) and FGF (fibroblast growth factor). Semi-quantitatively analysis was done in the laparotomy scars and in the abdominal walls far away from the site of the operation. Results: Assessing the weight of the animals, the correct inoculation of the tumor and weight gain in the group with tumoral ascites was observed. The histological studies showed that groups with the tumor showed a statistically significant higher presence of Cox-2 compared to the control. In the Cox-2 analysis of the abdominal wall, the ascites group showed the most significant difference. VEGF did not present any significant differences between the three groups, regardless of the site. The FGF showed a significant increase in animals with the tumor. Conclusion: Histological findings in both laparotomy scar and the abdominal wall showed that with Ehrlich's neoplasia there was an exacerbated inflammatory response, translated by more intense expression of Cox-2 and greater fibroblast proliferation, translated by more intense expression of FGF, that is, it stimulated both the immediate inflammatory reactions, observed with Cox-2 reactions, and late scarring by fibroblasts and FGF.