Experimental studies on the effect of pneumoperitoneum on tumour dissemination: clarification is required. Results of experimental trials should be further assessed

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Abstract
The authors carried out an analysis of the methodology used in experimental studies on the effect of pneumoperitoneum on tumour dissemination. Major papers published in the English language literature were included in the study. It appears that data on experimental models are scarce. Information concerning spontaneous survival, the ‘no‐take’ rate and patterns of tumour growth is generally not available. Significant differences are evident between papers which report new experimental models and those using similar models for surgical experiments. Similarly, surgical procedures are not discussed, despite some unusual procedures in terms of pneumoperitoneum pressure and number of trocars. Finally, only one paper gives a power calculation for the trial. These studies appear to be of a limited usefulness in the provision of new guidelines for clinical practice. The importance of the preoperative work up, of careful intraoperative assessment of suspicious lesions and of protected extraction of ovarian cysts were already known, and remain important.