Does laparoscopy increase bacteremia and endotoxemia in a peritonitis model?

Jacobi, C. A.; Ordemann, J.; Böhm, Birgit; Zieren, H. U.; Volk, Hans‐Dieter; Lorenz, W.; Halle, E.; Müller, J. M.

doi:10.1007/s004649900333

Cited by 57 publications

(40 citation statements)

References 13 publications

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“…Only a few controversial experimental data exist with regard to the effect of pneumoperitoneum on bacteremia and physiological changes in sepsis [15][16][17][18][19]. The aim of this study was to evaluate the effect of CO 2 pneumoperitoneum on endotoxemia and the proinflammatory cytokine response in intraperitoneal sepsis.…”

Section: Introductionmentioning

confidence: 99%

Effect of CO<sub>2</sub> Pneumoperitoneum on the Systemic and Peritoneal Cytokine Response in a LPS-Induced Sepsis Model

et al. 2001

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We studied the effect of carbon dioxide (CO₂) pneumoperitoneum on the systemic and peritoneal cytokine response in a rat model of intraperitoneal sepsis. After intraperitoneal injection of bacterial lipopolysaccharide (LPS, 10 mg/kg), rats were divided into 3 groups (n = 49 in each group): control (abdominal puncture); CO₂ pneumoperitoneum, and laparotomy. Blood and peritoneal lavage fluid (PLF) were sampled at 0, 1, 2, 3, 4, 6, and 8 h after LPS challenge. Blood cell counts, plasma endotoxin level, and the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in the plasma and PLF were measured. Blood cell counts did not differ between the 3 groups. Plasma endotoxin levels in the pneumoperitoneum group were significantly increased immediately after the procedure (p < 0.05). Although peak plasma TNF-α levels in the pneumoperitoneum group were seen immediately after the procedure, other changes in plasma cytokine levels did not differ significantly between the 3 groups. PLF TNF-α and IL-1β levels in the pneumoperitoneum group were significantly lower than levels in the control and laparotomy groups soon after the procedure (p < 0.05). PLF IL-6 levels in the pneumoperitoneum group tended to be lower than those in the laparotomy group. In conclusion, CO₂ pneumoperitoneum might induce different responses between systemic and peritoneal cytokines soon after the procedure in a rat model of intraperitoneal sepsis.

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Section: Introductionmentioning

confidence: 99%

Effect of CO<sub>2</sub> Pneumoperitoneum on the Systemic and Peritoneal Cytokine Response in a LPS-Induced Sepsis Model

et al. 2001

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“…It was observed that these values were significantly low in the CO 2 pneumoperitoneum-induced group, and it was reported that CO 2 pneumoperitoneum reduces inflammatory response in the peritoneum in the case of sepsis, when compared to open surgery. [22] In another study on pigs, it was found that the increase in the leukocyte and macrophage percentage was significantly low. Besides the low inflammatory response, it was observed that CO 2 pneumoperitoneum does not promote the bacteriemia or produce metabolic and hemodynamic problems in acute peritonitis.…”

Section: Discussionmentioning

confidence: 95%

“…İpek et al, [14] having studied the effects of CO 2 pneumoperitoneum on the degree of bacteriemia and peritonitis, observed that 1 hour after cecostomy, peritonitis severity scores were higher in the CO 2 pneumoperitoneum group than in the control group, but 3 to 6 hours after cecostomy, there was no difference between the groups. Jacobi et al, [22] in their experimental study investigating whether or not the laparoscopic interventions augment the bacteriemia and endotoxemia in the presence of peritonitis, reported that the laparoscopic interventions do not augment the bacteriemia and abscess processes.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] Some studies have shown that increased intraabdominal pressure via pneumoperitoneum may lead to the increased risk of bacterial translocation and bacteremia. [15][16][17][18][19][20][21][22][23][24][25][26] Some studies have shown that CO 2 has immunosuppressive effects on neutrophil and macrophage function, and CO 2 -induced immunosuppression might be deleterious in the setting of infection. [27,28] It has been argued as well that CO 2 pneumoperitoneum may cause malignant hypercapnia and toxic shock syndrome in the cases with peritonitis.…”

mentioning

confidence: 99%

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The effect of carbondioxide pneumoperitoneum on the severity peritonitis

Uzunköy¹,

Özardalı²,

Çelik³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇJeneralize peritonit olgularında hala, laparoskopik girişimlerin güvenilirliği ile ilgili kaygılar devam etmektedir. Bu deneysel çalışmada, deneysel peritonit oluşturulan sı-çanlarda karbondioksit (CO 2 ) pnömoperitonyumun enflematuvar cevap ve peritonit şiddeti üzerine etkilerinin araş-tırılması amaçlandı. GEREÇ VE YÖNTEMÇalışmada 21 Wistar albino cinsi sıçan kullanıldı. Sıçanlar üç gruba ayrıldı. Bunlar; kontrol (grup 1), bakteriyel peritonit oluşturulan grup (grup 2) ve peritonit + CO 2 pnömo-perituan oluşturulan grup (grup 3) idi. İkinci ve üçüncü gruptaki sıçanların periton içine Escherishia coli verilerek peritonit oluşturuldu. Üçüncü gruptaki sıçanlarda CO 2 insuflasyonu ile pnömoperitonyum oluşturuldu. Sıçanlar 24 saat sonra öldürüldü, kan ve karın duvarından periton ör-neği alındı. Tüm gruplarda peritonit şiddet skoru, C-reaktif protein düzeyi ve kanda beyaz küre sayısı değerlendirildi. BULGULARPeritonit şiddet skoru, C-reaktif protein düzeyi ve kan beyaz küre sayısı, ikinci ve üçüncü gruplarda, birinci gruba göre anlamlı düzeyde yüksek bulundu (p<0,05). Üçüncü grupta değerler, ikinci gruptan anlamlı düzeyde düşük bulundu (p<0,05). SONUÇÇalışmamızın sonuçları, CO 2 pnömoperitonyumun Escherishia coli ile peritonit ve sepsis oluşturulan sıçanlarda peritonit şiddetini ve sistemik enflematuvar yanıtı azalttığı-nı göstermiştir.

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“…In an animal model of long-term sepsis obtained by gastric perforation in pigs, a significant increase in the extent and severity of peritonitis and bacteremia was observed after treatment by videolaparoscopy 3 . On the other hand, in another study using a model of peritonitis induced by inoculation of feces into the peritoneal cavity of rats, laparoscopy was not associated with a significant increase in bacteremia 4 . Among the limitations of videolaparoscopic access for the treatment of peritonitis, the most significant is the possibility that high intra-abdominal pressure in the presence of pneumoperitoneum will induce bacterial translocation, along with the attendant bacteremia and death…”

Section: Introductionmentioning

confidence: 84%

Development of a lethal model of peritonitis for assessment of laparoscopic and laparotomic treatments in rats

Júnior¹,

Santos²,

Cunha³

2007

Acta Cir. Bras.

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Purpose: Development of a lethal model of peritonitis to assess the results of treating that peritonitis using videolaparoscopy and laparotomy. Methods: We developed a model of peritonitis in rats using cecal ligation (CLP) against a 2-mm diameter rigid mold and puncture. Two experiments were performed: determination of seven-day lethality; and analysis of white cell counts, blood cultures and cytokines (Interleukin-1 beta, Tumor Necrosis Factor-alpha and IL-6). The animals were divided into four groups: I -Sham surgery; II -CLP; III -CLP + Videolaparoscopy; and IV-CLP + Laparotomy . Results: Seven-day lethality was 0% in group I, 80% in the group II (p<0.05), 60% in group III , and 20 % in group IV. There was a significant reduction in leukocyte counts and higher levels of serum IL-1 beta, TNF-alpha and IL-6 in the group II compared to controls. The percentages of positive blood cultures were higher after videolaparoscopic compared to laparotomic treatment. Conclusion: The experimental model provoked a lethal form of peritonitis and that videolaparoscopic treatment had more bacteraemia than laparotomy. Key words: Peritonitis. Laparotomy. Laparoscopy. Cytokines. Lethality. Rats. RESUMO Objetivo:Desenvolvimento de um modelo letal de peritonite para avaliar o tratamento desta peritonite por videolaparoscopia e laparotomia. Métodos: Foi desenvolvido um modelo de peritonite em ratos utilizando ligadura do ceco (CLP) contra um molde rígido de 2mm de diâmetro, seguido de punção do órgão. Dois experimentos foram realizados: determinação da letalidade de 7 dias; e análise da leucometria, hemocultura e dos valores de citocinas (Interleucina-1 beta, TNF-alfa e IL-6). Os animais foram divididos em quatro grupos: I -Cirurgia simulada; II -CLP; III -CLP + Videolaparoscopia; e IV-CLP + Laparotomia . Resultados: A letalidade de sete dias foi de 0% no grupo I, 80% no grupo II (p<0.05), 60% no grupo III , e 20 % no grupo IV. Houve uma redução significativa na contagem de leucócitos e maiores níveis de citocinas séricas no grupo II quando comparado com o grupo controle. A porcentagem de hemoculturas positivas foi maior após videolaparoscopia quando comparado com o tratamento por laparotomia. Conclusão: O modelo experimental provocou uma forma de peritonite letal e que o tratamento por videolaparoscopia apresenta maiores taxas de bacteremia que o tratamento por laparotomia.

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Does laparoscopy increase bacteremia and endotoxemia in a peritonitis model?

Abstract: Laparoscopy does not increase bacteremia and intraperitoneal abscess formation compared to laparotomy in an animal model of peritonitis.

Cited by 57 publications

References 13 publications

Effect of CO<sub>2</sub> Pneumoperitoneum on the Systemic and Peritoneal Cytokine Response in a LPS-Induced Sepsis Model

Effect of CO<sub>2</sub> Pneumoperitoneum on the Systemic and Peritoneal Cytokine Response in a LPS-Induced Sepsis Model

The effect of carbondioxide pneumoperitoneum on the severity peritonitis

Development of a lethal model of peritonitis for assessment of laparoscopic and laparotomic treatments in rats

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