Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Abstract

Purpose: Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO 2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO 2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO 2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals. Key words: Pneumoperitoneum. Carbon Dioxide. Sepsis. Acidosis. Leucocytes. RESUMO Objetivo:A cirurgia laparoscópica está associada com trauma reduzido e baixa resposta na fase aguda do trauma, quando comparada com a cirurgia aberta. As citocinas e o balanço ácido-base são fatores importantes da resposta biológica ao trauma cirúrgico-anestésico. O objetivo deste estudo foi determinar se o pneumoperitôneo com CO 2 altera a expressão das citocinas, a gasometria e a contagem diferencial de leucócitos em ratos com sepse abdominal. Métodos: Ratos Wistar foram aleatoriamente distribuídos em 5 grupos: controle (somente anestesia), laparotomia, pneumoperitôneo com CO 2 , ligadura e punção do ceco por laparotomia, ligadura e punção do ceco por laparoscopia. Após 30 minutos dos procedimentos, sangue arterial foi colhido para leucometria diferencial em hemocitômetro. TNFα, IL-1β e IL-6 foram dosadas no líquido intraperitoneal (por ELISA). Os parâmetros gasosos foram medidos no sangue arterial e nos exsudatos intraperitoneal e subperitoneal. Resultados: Os valores de TNFα, IL-1β e IL-6 foram significantemente menores nos ratos submetidos ao pneumoperitôneo do que em...

Peritoneal inflammatory response of natural orifice translumenal endoscopic surgery (NOTES) versus laparoscopy with carbon dioxide and air pneumoperitoneum

“…Several studies have demonstrated that peritoneal fluid harbors a much greater concentration of cytokine markers [5][6][7] and therefore may provide a more accurate assessment of the local inflammatory response. Thus, the primary goal of this investigation was to assess the physiologic effect of NOTES compared with laparoscopy at the local peritoneal level while correlating the systemic response with serum cortisol.…”

“…In our previous work [1], we analyzed acute-phase protein markers of inflammation in serum samples and found very low or undetectable concentrations. Prior animal [5,6] and human [7] studies comparing laparotomy with laparoscopy have demonstrated much higher concentrations of inflammatory markers in peritoneal fluid than the levels routinely reported in serum after surgical stress [15]. Therefore, in this follow-up study, we began by comparing a positive control (OPEN) and a negative control (SHAM) to validate our model for collecting peritoneal fluid.…”

Comparison of prophylactic and therapeutic use of short-chain fatty acid enemas in diversion colitis: a study in Wistar rats

“…The animals were allowed to breathe spontaneously throughout the experiment. They were fixed in dorsal decubitus, and trichotomy and asepsis using povidone‐iodine were performed 16. …”

Stem Cells Hematopoietic Niches and Inflammatory Response to Different Synthetic Prosthesis Implanted in Rat With Incisional Hernias

“…Connective tissues, which are originated from mesenchyme, are rich in blood vessels, phagocytic and antibody-producing cells, as well as elastic and collagen fibers; their most common cells are fibroblasts (cells) and fibrocytes (mature cells). In normal connective tissue there can also be seen lymphocytes, eosinophils, mesenchymal undifferentiated and slightly differentiated cells that can turn into plasma cells, and macrophages (called histiocytes when tissue resident), with phagocytes aggressive agents, cellular debris, inert particles and which may form foreign body giant cells 3 , 12 , 27 .…”

“…Polypropylene is used since Usher pioneer work in 1958 and several options have been developed aiming at reducing inflammatory response to the implantation, like the diminishing used grammature of used material or the association of a smaller polypropylene framework to other absorbing material. However, triggered inflammatory response is significant, even with different materials available nowadays 2 , 3 , 11 , 16 , 22 , 25 , 29 .…”