Peritoneal Wall Research Articles

Immune Tumor Microenvironment in Ovarian Cancer Ascites.

Ovarian cancer (OC) has a specific type of metastasis, via transcoelomic, and most of the patients are diagnosed at advanced stages with multiple tumors spread within the peritoneal cavity. The role of Malignant Ascites (MA) is to serve as a transporter of tumor cells from the primary location to the peritoneal wall or to the surface of the peritoneal organs. MA comprise cellular components with tumor and non-tumor cells and acellular components, creating a unique microenvironment capable of modifying the tumor behavior. These microenvironment factors influence tumor cell proliferation, progression, chemoresistance, and immune evasion, suggesting that MA play an active role in OC progression. Tumor cells induce a complex immune suppression that neutralizes antitumor immunity, leading to disease progression and treatment failure, provoking a tumor-promoting environment. In this review, we will focus on the High-Grade Serous Carcinoma (HGSC) microenvironment with special attention to the tumor microenvironment immunology.

​The Downregulation of Pro-inflammatory Cytokine Interleukin-6 after Oral Administration of Lactobacillus plantarum IS-10506 in Mice Model for Endometriosis

Background: As a multi-functional cytokine, interleukin-6 (IL-6) is advanced in endometriosis. Probiotics are known to be able to modulate/regulate immune responses through downregulation of the pro-inflammatory cytokine IL-6. Lactobacillus plantarum IS-10506 (LIS-10506) is a novel probiotics strain derived from curd (a milk product which look like a yogurt) from traditionally made from buffalo milk or usually called by dadih from West Sumatra, Indonesia. This investigation intended to comprehend the impact of LIS-10506 administration on IL-6 expression in the endometrial tissue, serum IL-6 levels and endometriosis implant areas in mice model for endometriosis. Methods: This study conducted at the Animal Laboratory, Professor Nidom Foundation, Surabaya, Indonesia from January to June 2021. This experimental study was conducted on 32 adult female mice 12 weeks old divided into 4 groups in a completely randomized design with a posttest only control group design. LIS-10506 microencapsulation of curd was administered orally at a dose of 109 CFU/mice/day for 7 and 21 days. Serum IL-6 levels were assessed using IL-6 ELISA Kit for mice, IL-6 expression was assessed semi quantitatively according to the Remmele method and implant areas were measured by the area of hyperemia in mice’s peritoneal wall. Result: This investigation revealed that the peritoneal IL-6 expression and implant area experienced a decrease. In summary, the administration of LIS-10506 could downregulate pro-inflammatory cytokine IL-6. This present study has demonstrated the effect of LIS-10506 on one of the pathophysiological pathways in endometriosis.

Tubal flushing with oil-based contrast during transvaginal hydro laparoscopy, a case report.

Oil-based contrast has been shown to have a fertility-enhancing effect during hysterosalpingography (HSG) but is not yet used during transvaginal hydro laparoscopy (THL). To asses if additional tubal flushing with oil-based contrast during THL is feasible. Case report with video assessment. A healthy 29-year-old woman with primary unexplained subfertility, underwent a THL under local anaesthesia. First, chromopertubation was performed by methylene blue. Afterwards, tubal flushing with 3mL oil-based contrast (Lipiodol® UltraFluid, Guerbet) was performed. In this case report we evaluated the feasibility of additional tubal flushing with oil- based contrast during THL, in terms of; the visibility of the oil-based contrast at the tubal fimbriae, the pain and acceptability scores. Both fallopian tubes were patent to methylene-blue as well as to oil-based contrast. Interestingly, the oil-based contrast came out of the fallopian tube in the form of free droplets with strong internal bonding. Furthermore, some residue of the droplets was visible on the surface of the peritoneal wall in the form of oily micro-droplets. We present the first sub-fertile woman, in which additional tubal flushing with oil-based contrast during THL was performed. It is likely, that the residue of oily micro-droplets is also present inside the fallopian tube, where it may enhance the cilia movement by introducing lubrication. These lubricating characteristics of the oil-based contrast may be important for its fertility-enhancing effect. More research is necessary to confirm this hypothesis and the feasibility of tubal flushing with oil-based contrast during THL in more women.

V04-11 COMBINATION OF ROBOTIC-ASSISTED LAPAROSCOPIC PEDICLED PERITONEAL FLAP VAGINOPLASTY WITH PENILE SKIN INVERSION TECHNIQUE IN MALE-TO-FEMALE TRANSGENDER SURGERY. INSTRUCTIVE VIDEO-ARTICLE

You have accessJournal of UrologyCME1 May 2022V04-11 COMBINATION OF ROBOTIC-ASSISTED LAPAROSCOPIC PEDICLED PERITONEAL FLAP VAGINOPLASTY WITH PENILE SKIN INVERSION TECHNIQUE IN MALE-TO-FEMALE TRANSGENDER SURGERY. INSTRUCTIVE VIDEO-ARTICLE Eusebio Luna, Sidhbh Gallagher, Edward Gheiler, Ariel Kaufman, Luanda Perez, Dailianys Barrios, Melanie Milanes, and Fernando Bianco Eusebio LunaEusebio Luna More articles by this author , Sidhbh GallagherSidhbh Gallagher More articles by this author , Edward GheilerEdward Gheiler More articles by this author , Ariel KaufmanAriel Kaufman More articles by this author , Luanda PerezLuanda Perez More articles by this author , Dailianys BarriosDailianys Barrios More articles by this author , Melanie MilanesMelanie Milanes More articles by this author , and Fernando BiancoFernando Bianco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002560.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Gender-Affirming vaginoplasty comprises vulvar and vaginal canal creation.1 Those procedures can be considered separately, and we focus our video-article on vaginal canal construction. In male-to-female transgender surgery, penile skin inversion to line the neovagina is considered the gold standard procedure.2 In our experience, the combination of this technique with The Davydov procedure, commonly used for vaginoplasty in female patients with Mayer-Rokitansky-Kuster-Hauser-Syndrome (MRKH) 3 grants an excellent depth of the vaginal canal, and great comfort to the patient during vaginal intercourse. METHODS: This video abstract features the vaginal canal creation in a 33-year-old male with a long-standing history of gender dysphoria. The intervention starts with the peritoneal walls harvesting at the level of Douglas Pouch, to create a vascular pedicled peritoneal flap. Next, a careful robotic perineal body dissection allowed us establishing external communication of the neovaginal canal. Afterward, the robotic-assisted anastomosis between the previously dissected inverted penile skin and the peritoneal flap is carried. The vaginal cuff closure and colpopexy finish the intervention. RESULTS: Operative time was 140 minutes, blood loss 80 cc, a perineal pack, and a Foley catheter were placed after the intervention and removed on the 7th postoperative day. The patient remained hospitalized for two days. There were no reported complications other than some right labia minora epidermolysis on the 6th postoperative day which has since resolved. The vaginal dimension at the 4th postoperative month is 6 inches in depth. Periodic dilations with a 1.5 inches dilator are needed. CONCLUSIONS: The combination of robotic-assisted laparoscopic pedicled peritoneal flap vaginoplasty with penile skin inversion technique represents a feasible and reliable option for patients interested in male-to-female transgender surgery. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e370 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eusebio Luna More articles by this author Sidhbh Gallagher More articles by this author Edward Gheiler More articles by this author Ariel Kaufman More articles by this author Luanda Perez More articles by this author Dailianys Barrios More articles by this author Melanie Milanes More articles by this author Fernando Bianco More articles by this author Expand All Advertisement PDF DownloadLoading ...

Peritoneal carcinomatosis and mimicking on CT scan findings

Peritoneal carcinomatosis (PC) is a term to describe the distant spread (metastatic) of the primary tumor to the peritoneal cavity. PC is a late-stage manifestation of various gastrointestinal malignancies in general and affects the ovaries, which is characterized as tumor deposits involving the surface of the peritoneal wall. If no primary signs are found, the primary diagnosis can be considered from the peritoneum itself. PC itself can be found incidentally on imaging, which can be seen on computed tomography examination, but in some mimicking images making it difficult to make a diagnosis, it is necessary to correlate it with the histopathological results.

Rapid Visualization of Deeply Located Tumors In Vivo by Intravenous Administration of a γ-Glutamyltranspeptidase-Activated Fluorescent Probe.

We previously showed that spraying the fluorescent probe gGlu-HMRG (γ-glutamyl hydroxymethyl rhodamine green) can visualize even tiny tumors on the mesentery and peritoneal wall of tumor-bearing mice. However, during surgery, repeated spraying is necessary to detect tumors located deep within organs. Here, we examine whether deeply located tumors can be stained by intravenous administration of this probe. In mice bearing subcutaneous tumors, intravenous administration of gGlu-HMRG resulted in a rapid and specific increase of fluorescence in the tumor, which was visible to the naked eye within 5 min, and the maximum fluorescence intensity ratio of tumor to normal tissue (T/N = 4.3) was reached at 30 min. In mice bearing lung tumors, the T/N ratio reached approximately 20 at 30 min after administration, and deeply located tumors were clearly visualized. These results suggest that intravenous administration of gGlu-HMRG may be a useful technique in fluorescence-guided surgery of tumors.

Combinatory effects of current regimens and Guizhi Fuling Wan on the development of endometriosis

ObjectiveEndometriosis, defined as the growth of endometrial glands and stromal cells in a heterotopic location under the cyclic influence of ovarian hormones, is a common gynecological disorder manifested by chronic pelvic pain and infertility. In traditional Chinese medicine, endometriosis is characterized by stagnation of vital energy (qi) and blood stasis. Guizhi Fuling Wan (GFW) was first described in Chinese canonical medicine to treat disorders associated with stagnation of qi and blood stasis, including endometriosis. Therefore, the current study aimed to test the effects of combining GFW with western medicine on the suppression of endometriosis. Materials and methodsEndometriosis was generated by suturing endometrial tissue on the peritoneal wall of C57BL/6JNarl mice. The mice were subsequently treated with either GFW or current hormonal therapies or in combination for 28 days. ResultsEndometriosis development was inhibited by GFW, Gestrinone, Visanne, GFW + Gestrinone or GFW + medroxyprogesterone acetate (MPA). The expression of intercellular adhesion molecule 1 (ICAM-1) was inhibited by GFW, Gestrinone, MPA, Visanne, GFW + Gestrinone, GFW + MPA and GFW + Visanne. Vascular endothelial growth factor (VEGF) expression was inhibited by GFW, Gestrinone, Visanne, GFW + Gestrinone and GFW + MPA. Both ICAM-1- and VEGF-reducing effects of GFW were attenuated by western medicines. Administration of GFW, MPA, Visanne, GFW + MPA and GFW + Visanne also correspondingly reduced macrophage population in peritoneal fluid. GFW, MPA, Visanne, GFW + MPA and GFW + Visanne enhanced B-cell population in peritoneal fluid. ConclusionThe current study reveals the therapeutic effects of GFW on endometriosis. However, the combination of GFW and current hormonal therapies potentially impedes the efficacy of each individual agent in treating endometriosis.

Presentation of Acute Lymphoblastic Lymphoma and Colorectal Carcinoma in the Context of Constitutional Mismatch Repair Deficiency Syndrome: A Case Report with Literature Review.

Constitutional mismatch repair deficiency (CMMRD) is a rare autosomal recessive disease carrying an increased risk of cancers (paediatric tumours of central nervous system, haematolymphoid malignancies along with gastrointestinal (GI) cancer(s), which are usually seen in the second and third decades), leading to syndromic presentation. Causal mutations are detected in DNA mismatch repair (MMR) genes, including MLH1, PMS2, MSH2 and MSH6 that are also known for their established role in Lynch syndrome. We describe a case of CMMRD with an earlier (first decade of life) presentation of mediastinal acute lymphoblastic lymphoma and colorectal malignancy. A 5-year-old boy presented with respiratory complaints, bilateral cervical lymphadenopathy, multiple café-au-lait macules (CALMs) on the lower back and history of parental consanguinity with the death of three sisters due to brain tumour within 6 months of diagnosis. Computerised tomographic scan chest revealed a huge mediastinal mass. The patient underwent a trucut biopsy of the mass. The results were significant for a pre-T-cell acute lymphoblastic lymphoma. Suspicion of CMMRD was raised based on a combination of factors described above. A panel of MMR proteins was applied on the biopsy tissue that revealed loss of nuclear expression of MLH1 and PMS2 immunostaining in tumour cells with positive external controls. While on maintenance therapy for lymphoma, about a year later, the patient developed subacute intestinal obstruction due to a stenosing polypoidal circumferential tumour in the mid-sigmoid colon found on flexible sigmoidoscopy that was followed by endoscopic biopsies and insertion of a fully covered self-expanding metallic adult biliary stent with a diameter of 10 mm and length of 6 cm leading to immediate relief of obstruction. Biopsies revealed adenocarcinoma with neuroendocrine differentiation. Metastatic tumour deposits were seen in the omentum, anterior abdominal wall and the left peritoneal wall. Earlier (first decade) presentation of GI malignancy warrants that an earlier screening through radiological scans for any possible tumours and MMR protein expression analysis (loss in tumour plus normal non-tumour cells) are essential in patients having CALMs and family history of paediatric tumours.

Volume-Independent Sodium Toxicity in Peritoneal Dialysis: New Insights from Bench to Bed

Sodium overload is common in end-stage kidney disease (ESKD) and is associated with increased cardiovascular mortality that is traditionally considered a result of extracellular volume expansion. Recently, sodium storage was detected by Na23 magnetic resonance imaging in the interstitial tissue of the skin and other tissues. This amount of sodium is osmotically active, regulated by immune cells and the lymphatic system, escapes renal control, and, more importantly, is associated with salt-sensitive hypertension. In chronic kidney disease, the interstitial sodium storage increases as the glomerular filtration rate declines and is related to cardiovascular damage, regardless of the fluid overload. This sodium accumulation in the interstitial tissues becomes more significant in ESKD, especially in older and African American patients. The possible negative effects of interstitial sodium are still under study, though a higher sodium intake might induce abnormal structural and functional changes in the peritoneal wall. Interestingly, sodium stored in the interstial tissue is not unmodifiable, since it is removable by dialysis. Nevertheless, the sodium removal by peritoneal dialysis (PD) remains challenging, and new PD solutions are desirable. In this narrative review, we carried out an update on the pathophysiological mechanisms of volume-independent sodium toxicity and possible future strategies to improve sodium removal by PD.

Resident macrophage-dependent immune cell scaffolds drive anti-bacterial defense in the peritoneal cavity

Peritoneal immune cells reside unanchored within the peritoneal fluid in homeostasis. Here, we examined the mechanisms that control bacterial infection in the peritoneum using a mouse model of abdominal sepsis following intraperitoneal Escherichia coli infection. Whole-mount immunofluorescence and confocal microscopy of the peritoneal wall and omentum revealed that large peritoneal macrophages (LPMs) rapidly cleared bacteria and adhered to the mesothelium, forming multilayered cellular aggregates composed by sequentially recruited LPMs, B1 cells, neutrophils, and monocyte-derived cells (moCs). The formation of resident macrophage aggregates (resMφ-aggregates) required LPMs and thrombin-dependent fibrin polymerization. E.coli infection triggered LPM pyroptosis and release of inflammatory mediators. Resolution of these potentially inflammatory aggregates required LPM-mediated recruitment of moCs, which were essential for fibrinolysis-mediated resMφ-aggregate disaggregation and the prevention of peritoneal overt inflammation. Thus, resMφ-aggregates provide a physical scaffold that enables the efficient control of peritoneal infection, with implications for antimicrobial immunity in other body cavities, such as the pleural cavity or brain ventricles.

A View from the Shoulders of Giants

Although minimally invasive surgery has reduced postoperative pain and length of hospital stay after right hemicolectomy, identification of anatomic landmarks is critical in ensuring safe technique through the narrow lens of the laparoscope. Well-known anatomical eponyms, such as the fold of Treves and Gerota's fascia, are commonly referenced during the teaching of this procedure when performing mobilization of the right colon off the peritoneal wall and entry into the lesser sac. In addition, there are lesser-known landmarks involved in this procedure, such as the Bouchet area and Fredet's fascia, that facilitate access to the lesser sac and bloodless dissection planes. However, little is usually known about the biographical information of the physicians after whom these landmarks are named. To enhance the teaching of this procedure, the steps involved in a right hemicolectomy with their corresponding eponymous landmarks are narrated alongside the biographical background of each of the physicians after whom they are named.

Transcriptome-Based Analysis Reveals Therapeutic Effects of Resveratrol on Endometriosis in aRat Model.

IntroductionEndometriosis (EMs) is associated with severe chronic pelvic pain and infertility and the development of improved EMs treatment options is an ongoing focus. In this study, we investigated the effects of resveratrol on EMs and analyzed transcriptional changes in the lesions of model rats before and after resveratrol treatment.MethodsWe established arat model of endometriosis through the trans-implantation of endometrial fragments to the peritoneal wall and then used resveratrol as treatment. We then analyzed the results using RNA sequencing of the lesion tissues of each of the model rats before resveratrol treatment and the reduced lesion tissues after the treatment. Examinations of anatomy, biochemistry, immunohistochemical staining and flow cytometry examinations were also conducted. Other trans-implanted rats were also given sham treatments as sham-treatment control and other untrans-implanted rats served as sham-operation controls.ResultsIn addition to the obvious lesions observed in the model rats, there were significant differences in the glucose tolerance, macrophage M1/M2 polarization, and adipocyte sizes between the treated model rats and sham (control) rats. Resveratrol treatment in the model rats showed significant efficacy and positive therapeutic effect. Transcriptional analysis showed that the effects of resveratrol on the endometriosis model rats were manifested by alterations in the PPAR, insulin resistance, MAPK and PI3K/Akt signaling pathways. Correspondingly, changes in PPARγ activation, M1/M2 polarization and lipid metabolism were also detected after resveratrol treatment.DiscussionOur study revealed that resveratrol treatment displayed efficient therapeutic effects for EMs model rats, probably through its important roles in anti-inflammation, immunoregulation and lipid-related metabolism regulation.

P–316 A rat model of endometrioma to study endometriosis-related infertility

Abstract Study question Underlying mechanisms and specific treatment for endometriosis-related infertility are still unclear and lacking. Is there any animal model suitable for the study? Summary answer Endometium ligation to ovary fat pad in rats is a more appropriate and successful but less detrimental model of endometrioma for infertility pathology and outcomes. What is known already Nonhuman primates (NHP) have been the most representative animal model for endometriosis since they menstruate in a cyclic pattern and develop endometriosis spontaneously as in human. However, the incidence of spontaneous endometriosis in NHP is low and due to ethical concerns and high cost, the application of NHP for endometriosis study is restricted. Rodents (i.e. rats, mice, rabbits) have been used to analyze the pathophysiology of endometriosis. Because rodents do not develop endometriosis spontaneously, it has to be induced surgically. Ovarian endometriosis is the most common type, but previous experimental models were mostly either subcutaneous, peritoneal wall or mesenteric endometriosis. Study design, size, duration An animal study to compare different methods of endometrium transplantation to the ovary as potential animal model of endometrioma to study the endometriosis-related infertility. Compared with NHP and other rodents, rats were chosen due to easy access, low cost, good ovary size, short estrus and reproductive cycle and similar endocrine pattern to human beings. For each transplantation method, at least 5 animals were included and followed up in different time points for comparisons. Participants/materials, setting, methods To establish ovarian endometriosis or endometrioma model, uterine tissues were collected from donor rats and then transplanted to recipient rats by either adhesion to ovary, ligation to ovary fat pad, or injection underneath tunica albuginea. Vasculature and histology of engrafts, follicle count and morphology of ovary, receptivity markers of endometrium, immune response and inflammatory cytokines of peritoneal cavity and hormonal changes were assessed after 4 days of transplantation. Implantation rates after conception will be examined. Main results and the role of chance Compared with other transplantation methods, only ligation of endometrium fragments to ovary fat pad resulted in endometrioma-like lesion in the ovaries. Compare with sham control ovaries, formation of new vessels from surrounding ovarian vessels to the endometriotic engraft assessed by Cellvizio LAB in vivo imaging was identified, indicating active angiogenesis. Morphology and histology of endometriotic cyst were confirmed in the lesion by H&E staining, suggesting functional endometrium. Stroma markers CD140b, CD106 lkand epithelium markers keratin 17/19 and EpCam were found in the ovary cortex, implying integration of endometrium tissue to the ovarian tissues. Decreased AMH expression and antral follicle count in the ovaries suggested defective follicle development. Reduced receptivity markers HOXA10, LIF and ανβ3 integrin expression in uterine endometrium and implantation rate after nature mating or embryo transfer indicated potential impaired endometrial receptivity. Peripheral and peritoneal levels of COX2 and IL–8 were elevated, suggesting inflammatory response. However, estrogen and progesterone levels were not significant different from baseline and other transplantation methods. Limitations, reasons for caution This was an animal model, it might not totally reflect the exact pathological changes of endometrioma in human. Current method was a single and short-term transplantation model, monthly endometrial cells engraftment and slow growing lesions without sufficient estrogen supply might limit the establishment of endometrium-like lesions. Further testings are needed. Wider implications of the findings: Establishment of animal models for endometrioma is vital important to investigate the pathophysiology, underlying mechanism and potential therapy targets for endometriosis-related infertility. Currently such model is still lacking. An appropriate, adequate and effective but less detrimental model of endometrioma can accelerate the scientific research and clinical application in near future. Trial registration number N/A

How to Prevent Peritoneal Dialysis Catheter Tip Migration: A Japanese Perspective

The prevention of peritoneal dialysis (PD) catheter complications is essential to achieve a successful outcome. In recent years, nephrologists have performed more PD catheter insertion surgeries in Japan. The prevention of catheter complications is crucial for nephrologists who do not have all-around surgical skills. PD catheter tip migration is a common complication and a significant cause of catheter malfunction. Several preventive techniques have been reported for the PD catheter tip migration. This perspective described the following: (1) surgical technique in laparotomy, (2) laparoscopic surgery, (3) peritoneal wall anchor technique, and (4) catheter type selection. We hope that more effective methods of preventing catheter complications will be developed to ensure the success of PD treatment.

Abstract 3001: Multicellular structures of serous ovarian cancer nature isolated from pleural effusions are sufficient to recreate peritoneal carcinomatosis in immunosuppressed mice

Abstract High-grade serous ovarian cancer (HGSOC) is a lethal disease often diagnosed in grade III International Federation of Gynecology and Obstetrics (FIGO) upon colonization of the peritoneal cavity, or in grade IV FIGO when it colonizes the pleural cavity. When in the pleural cavity, the disease often manifests with accumulation of pleural effusions containing multicellular structures (MCS). In this work, we studied whether MCS isolated from a pleural effusion of a patient that did not respond to chemotherapy are sufficient to cause peritoneal carcinomatosis in immunosuppressed mice when implanted orthotopically. Nude mice were injected intraperitoneally with MCS isolated from the pleural effusions of a heavily treated patient. We determined the time taken for the disease to develop, the tissues targeted, presence or absence of ascites, the macroscopic and microscopic disease appearance, and the expression of standard biomarkers of HGSOC. We contrasted the histopathology of the tumors recreated in mice against that of the original tumor taken during diagnostic surgery. MCS from pleural effusions were sufficient to recreate disease in the mice, which reached their humane-endpoint seven months following MCS injection (n=3). The animals developed abundant cellular peritoneal ascites. In addition, macro and microscopic discrete disease was observed in the fat surrounding the ovaries, the omental-pancreatic area, the peritoneal wall, a lymph node, the diaphragm, and the lung. The histopathology of the disease showed infiltrating papillary architecture, areas with cells arranged in a solid pattern, and tumor nests with slit-like lumens that stained positive for mutant p53, p16, and WT1. Our results provide proof of principle that MCS isolated from pleural effusions of a HGSOC patient are sufficient to recreate peritoneal carcinomatosis in nude mice, depicting most morphological features found at postoperative diagnosis. Citation Format: Alicia A. Goyeneche, Ashwyna Sunassee, Sabrina J. Ritch, Michael Koch, Maria Bell, Zu-hua Gao, Carlos M. Telleria. Multicellular structures of serous ovarian cancer nature isolated from pleural effusions are sufficient to recreate peritoneal carcinomatosis in immunosuppressed mice [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 3001.

Abstract 2897: The metastatic potential of high-grade serous ovarian cancer cells along disease progression

Abstract Epithelial ovarian cancer (EOC) represents 90% of all ovarian tumors and is considered to be the deadliest gynecological disease. High grade serous ovarian cancer (HGSOC) is the most aggressive form of EOC and represents 70% of all deaths from the disease. Due to a lack of early symptoms and valid screening methods, HGSOC is often diagnosed at late stages, when metastasis has already occurred. HGSOC disseminates from the primary tumor as single cells or clusters that typically adheres to the peritoneal organs and wall. The purpose of this study was to characterize the migratory, invasive, and adhesive abilities of HGSOC cells representing different stages of disease evolution. Both wound healing (WH) and Boyden chamber (BC) assays were performed to study the migratory capacity of five HGSOC cell lines; PEO1, PEO4 and PEO6, from a first patient, and PEO14 and PEO23, from a second patient. The cell lines were generated along different stages of the disease (e.g. at presentation, recurrence, and before death), thus representing disease evolution. To study the invasive capacity of each cell line, a layer of extracellular matrix was added to the BC assays. Adhesion assays were performed on fibronectin coated plates. It was found that the migratory and invasive capacities of the HGSOC cell lines decreased along disease evolution in both cellular series. PEO1 and PEO14, two chemo-sensitive cell lines, were found to have the highest migratory and invasive capacities, while their chemoresistant counterparts, PEO4, PEO6 and PEO23, showed a decrease in migration and invasion. Moreover, a distinct migration pattern was found to be conserved in both WH and BC assays. Cell lines representing an early stage disease had a tendency to migrate as individual cells, while cells representing a late stage disease were observed migrating in clusters. Adhesion rates were found to be similar between all cells lines. The results suggest that HGSOC disease progression seems to be associated with reduced migratory and invasive capacities, contradicting the idea that advanced stage EOC cancers have higher metastatic potential. Citation Format: Sabrina J. Ritch, Alicia A. Goyeneche, Abu S. Noman, Carlos M. Telleria. The metastatic potential of high-grade serous ovarian cancer cells along disease progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2897.

Comparison of Incident of Chronic Pain Post Operations of Preperitoneal Transabdominal Herniorafi Laparoscopy (TAPP) and Totally Extraperitoneal (TEP) in General Hospital Dr. M. Djamil Padang

A B S T R A C TIntroduction : Inguinal herniation is a protrusion of peritoneal component throughabdominal wall caused by the weakness of aponeurotica tissue of abdomen. Inguinalherniation is the most common herniation cases in which 291.145 patient registeredin Indonesia at 2012 and 87 patients in General Government Hospital of M. DjamilPadang at 2017-2018. Herniation treatment is consisted of herniorrhapylaparoscopy using the TEP or TAPP techniques and both of them are related to theincidence of chronical post-operative pain that was defined by IASP as anuncomfortable sensation lasting for more than 3 months. Method: This researchwas using retrospective study design. The research was conducted at RSUP Dr. M.Djamil Padang in August – October 2020 with 54 samples. Result: The study foundthere was 54 cases of inguinal herniation fit to the inclusion criteria with peak ageof 82 years old and average of 59.1 years old. Most patients were male (79.62 %).There were 2 patients having chronic pain (7.41%) after herniorrhapy using the TAPPtechnique and 1 more (3.71%) having chronic pain with TEP technique. Bivariateanalysis was done by Fisher Exact Test and the study concluded there was nostatistical significance in relationship of chronic post-operative pain incidence withthe particular technique chosen at herniorrhapy laparoscopy (p=1.000). Conclusion:There was no significant relationship between the incidence of postoperative chronicpain in patients undergoing laparascopic hernioraphy and TEP or TAPP procedure.

Pseudocisto perirenal extracapsular em um gato: relato de caso

Perirenal pseudocyst is a disorder rarely reported in domestic animals. It is characterized by the accumulation of fluid in a fibrous sac around one or both kidneys. When fluid accumulates between the renal capsule and the peritoneal wall, it is classified as extracapsular or retroperitoneal. The objective was to report the case of a two-year-old mixed breed cat, attended with complaints of bloating and anorexia. The ultrasound examination revealed images compatible with perirenal peseudocyst, showing a large volume of fluid involving both kidneys. The treatment instituted was through the total capsulotomy procedure with omentalization. The capsulotomy procedure proved to be a very effective procedure, without the presence of complications or recurrences, in the surgical resolution of the extracapsular perirenal pseudocyst with accumulation of transudate, with no apparent cause.

Successful treatment of recurrent volvulus in the afferent limb of the pouch following proctocolectomy for ulcerative colitis: a case report

BackgroundPouch volvulus after proctocolectomy for ulcerative colitis is a very rare postoperative complication. The common site of pouch volvulus has been reported to be the ileal pouch–anal anastomosis and the middle part of the pouch, but no reports on pouch volvulus in the afferent limb of the pouch have been observed. Here, we report the case of a patient with afferent limb volvulus who underwent afferent limbpexy, but required reoperation 7 months later.Case presentationA 38-year-old man with refractory ulcerative colitis had undergone open proctocolectomy 10 years ago at another hospital. He had been aware of lower abdominal pain and bowel movement difficulty for 2 years. After repeated bowel obstruction, he was referred to our hospital for surgery. Based on the radiographic findings, we diagnosed a pouch volvulus and performed an operation. Laparoscopically, counterclockwise rotation of the afferent limb of the pouch was recognized. Moreover, the ileal mesentery was adhered and fixed to the presacral space 20 cm from the oral side of the pouch. The antimesenteric side of the afferent limb was fixed using interrupted stiches on the left peritoneal wall of the pelvis. He was discharged uneventfully 18 days after surgery, and defecation improved immediately. However, he was readmitted 7 months after surgery with the same abdominal pain and defecation difficulty. A similar finding was found and diagnosed as recurrent volvulus. Therefore, we performed a laparoscopic surgery. The same volvulus as in the previous surgery was confirmed. The site fixed during the previous surgery showed scars, but the afferent limb was free. The dilated ileum that contained the volvulus was excised only on the oral side of the pouch and an intraluminal anastomosis was performed on the anterior wall of the pouch. He had a good postoperative course and was discharged.ConclusionProper diagnosis of volvulus based on the characteristic imaging findings is important. In principle, bilateral row fixation of the rotated ileum is the basic procedure for volvulus. However, fixation with this technique is sometimes difficult. Therefore, this procedure is one of the useful options for the fixation of difficult or recurrent cases.

Novel ovarian endometriosis model causes infertility via iron-mediated oxidative stress in mice

Ovarian endometriosis (OE) provides women of reproductive age with not only severe menstrual pain but also infertility and an increased risk for ovarian carcinogenesis. Whereas peritoneal endometriosis models have been developed with syngeneic implantation of minced uterine tissue and oncogenic K-ras allele with conditional Pten deletion within ovarian surface epithelium generated preneoplastic endometrial glandular morphology, followed by endometrioid adenocarcinoma, there has been no mouse model of OE similar to human counterparts, applicable to preclinical studies. Here we for the first time established a murine OE model that reveals infertility, and evaluated the involvement of iron catalyzed oxidative stress in the pathogenesis. Minced uterine tissue from female mice was implanted on ovarian surface of syngeneic mice after bursectomy to induce OE. Ectopic growth of endometrium was observed in association with ovary 4 weeks after implantation in 85.7% (12/14) of the operated mice with our protocol. Endometriotic lesions involved intestine, pancreas and peritoneal wall. Fibrosis around the ovary was prominent and increased time-dependently in the OE group. Iron accumulation was significantly increased in the OE group, leading to oxidative stress in each stage of the follicles as evaluated by 4-hydroxy-2-nonenal-modified proteins and 8-hydroxy-2′-deoxyguanosine. Expression of follicle stimulating hormone receptor in the follicles revealed a significant decrease during pre-antral, antral and pre-ovulatory phases in the OE group. Finally, the number of pups was significantly reduced in the OE group in comparison to the controls. This model affords an opportunity to evaluate agents or procedures to counteract ovarian endometriosis in the preclinical settings.