Anatomical preconditions for development and clinical course for patients with peritoneal carcinomatosis

Objective. The objective of the paper is to evaluate serous lymph hatches (SLHs) of parietal peritoneum and to examine their influence on pathogenesis of cancer cell dissemination. The authors take into consideration alternative theories of peritoneal carcinomatosis (PC) development. Materials and Methods. Anatomic materials of parietal peritoneum from diaphragm to pelvic floor taken from fresh cadavers were examined. Studies of peritoneal surface area were performed using threedimensional light microscopy (3-D image; 6-, 12-, and 25-multiple lenses; light-optical microscope). Scanning electron microscope Tescan Vega-3SBH (Czech Republic) was used for in-depth nano-anatomical study. Fine coat Ion sputter JFC 1100 (JEOL, Japan) was used to dry and clean the samples by means of ion-plasma etching. Results. Image analysis of the intact parietal peritoneum from diaphragm to pelvic floor was conducted during the trial. The authors focused their attention on evaluation of serous lymph hatches, submesothelial relief-forming structures, being the most important ones in pathogenesis of peritoneal carcinomatosis in terms of lymphogenous (alternative) cancer metastasis theory. Conclusion. The research conducted allowed to examine anatomical features of the intact parietal peritoneum in detail and to understand the mechanisms of PC development from the perspective of alternative theories. The abovementioned theory of PC development does not exclude the implant nature of peritoneal lesion in cancer. It helps to consider metastasis of the peritoneal cancer in a different way.