Stress response and well-being after open, laparoscopic, and NOTES transgastric uterine horn resection in a randomized porcine model

Bergström, Maria; Azadani, Asghar; Falk, Peter; Park, Per-Ola

doi:10.1007/s00464-014-3491-0

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…This transient elevation occurred in all 3 groups of animals with no statistically significant difference even though the rise of CRP levels was gradual in the TG animals and continued until day 7. The finding of a transient elevation of CRP is consistent with other reports [ 19 , 33 , 34 , 36 ]. Martínek et al and Freeman et al, in studies of ovariectomies in dogs and pigs, also found an early increase in CRP on days 1 and 2, which was greater in the NOTES animals than in laparoscopic controls [ 19 , 33 ].…”

Section: Discussionsupporting

confidence: 92%

“…Martínek et al and Freeman et al, in studies of ovariectomies in dogs and pigs, also found an early increase in CRP on days 1 and 2, which was greater in the NOTES animals than in laparoscopic controls [ 19 , 33 ]. In contrast, a recent study of Bergström et al reported lower CRP levels on day 1 following NOTES uterine horn resection [ 36 ]. Others investigators, such as Sohn et al and Vieira et al, did not find significant differences in CRP levels after rectosigmoid resection or cholecystectomy in pigs [ 29 , 31 ].…”

Section: Discussionmentioning

confidence: 89%

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Comparison of Inflammatory Response to Transgastric and Transcolonic NOTES

Hucl

Benes

Kočík

et al. 2016

Gastroenterology Research and Practice

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Aims. The aim of our study was to determine the physiologic impact of NOTES and to compare the transgastric and transcolonic approaches. Methods. Thirty pigs were randomized to transgastric, transcolonic, or laparoscopic peritoneoscopy. Blood was drawn and analyzed for C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin- (IL-) 1β, IL-6, WBCs, and platelets. Results. Endoscopic closure with an OTSC was successful in all 20 animals. The postoperative course was uneventful in all animals. CRP values rose on day 1 in all animals and slowly declined to baseline levels on day 14 with no differences between the groups (P > 0.05, NS). The levels of TNF-α were significantly increased in the transcolonic group (P < 0.01); however this difference was already present prior to the procedure and remained unchanged. No differences were observed in IL1-β and IL-6 values. There was a temporary rise of WBC on day 1 and of platelets on day 7 in all groups (P > 0.05, NS). Conclusions. Transgastric, transcolonic, and laparoscopic peritoneoscopy resulted in similar changes in systemic inflammatory markers. Our findings do not support the assumption that NOTES is less invasive than laparoscopy.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 89%

Comparison of Inflammatory Response to Transgastric and Transcolonic NOTES

Hucl

Benes

Kočík

et al. 2016

Gastroenterology Research and Practice

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“…Although it sounds reasonable, results are rather inconsistent – not because the theory is wrong but because of other factors that are involved, such as the inflammatory reaction of the peritoneum caused by visceral port-site trauma, possible enteral content spillage, and longer operative time. 37 – 41 …”

Section: Discussionmentioning

confidence: 99%

The Length of Surgical Skin Incision in Postoperative Inflammatory Reaction

Ioannidis

Arvanitidis

Filidou

et al. 2018

JSLS

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Background and Objectives:Surgery provokes inflammatory and immune responses, so efforts have been made to reduce host response by using less invasive techniques. The purpose of this experimental study was to investigate the surgical stress induced by skin incision and the role of liver response in this process.Methods:Seventy male anesthetized Wistar rats were subjected to a midline incision confined strictly to the skin (dermis) of either 1 cm long (n = 20), 10 cm long (n = 20), or no incision (n = 20) or served as controls (n = 10). Skin trauma was left open for a 20-minutes period, and then was meticulously sutured. At 3 and 24 hours later, laparotomy was performed on half the rats of each group, for blood and liver sampling. In serum and liver homogenates, cytokine-induced neutrophil chemoattractant (CINC)1/interleukin (IL)-8 and tumor necrosis factor (TNF)-α levels were measured with enzyme-linked immunosorbent assays and nitric oxide (NO) using a Griess reaction.Results:Skin trauma was found to significantly (P < .01) increase all inflammatory mediators tested (CINC1/IL-8, TNF-α, NO) in serum of operated rats versus controls, the increase being proportionally dependent on the length of skin incision. In liver homogenates, CINC1/IL-8 was significantly (P < .01) increased in operated animals versus controls, similarly to serum levels. In contrast, liver TNF-α levels were inversely related to serum levels, and a significant (P < .01) decrease in TNF-α was observed in liver homogenates of operated animals compared with the controls, indicating that the increased TNF-α in blood reflects liver TNF-α secretion.Conclusion:Our findings suggest that inflammatory and immune reactions induced by skin-only surgical trauma are closely correlated to the length of skin incision.

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“…6 A study describing the acute phase reaction in pigs following thorax surgery was published in 2016. 7 Some studies claim that a laparotomy procedure leads to a stronger acute phase and immune response than less invasive methods such as laparoscopy 8 or natural orifice transluminal endoscopic surgery (NOTES), 9 but a general view of the immediate changes in CRP, serum proteins or the white blood cell count in pigs following abdominal surgery is lacking in published literature. A pilot study made at the Norwegian School of Veterinary Science in 2009 measured C-reactive protein (CRP), haptoglobin and fibrinogen in 40 pigs post-surgery (Tore Framstad, personal communication).…”

Section: Introductionmentioning

confidence: 99%

Acute phase response and hematology in pigs after cryptorchidism or inguinal hernia surgery

Kaas¹,

Cohen²,

Framstad³

2018

JDVAR

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Invasive surgery is a strain to the body, and many pigs undergo abdominal surgery in field practice. An observational study was performed to investigate changes in the composition of serum proteins, including acute phase proteins, and white blood cells after cryptorchidism or inguinal hernia surgery. Blood samples were collected one day before surgery and one, three, six and fourteen days after surgery. The study showed an average increase of 45.52 mg/L in C-reactive protein (CRP) day one after surgery compared to the day before surgery (p<0.0001). CRP levels were normalized on day fourteen post-surgery. On day three postsurgery, α-and β-globulins were significantly higher than before surgery. Albumin was significantly decreased on day six (p<0.01) post-surgery. On day fourteen post-surgery, total protein, α-, β-and γ-globulins were 3.45 g/L (p<0.01), 0.94 g/L (p<0.05), 1.14 g/L (p<0.001) and 2.97 g/L (p<0.0001), respectively, higher than the levels pre-surgery. There was an increase in the numbers of white blood cells from the day before surgery until the sixth day after surgery (p<0.05) and an increase in neutrophil granulocytes (NG) from the day before surgery until the day after surgery (p<0.05). The NG number stayed significantly increased throughout the test period. The average percentage amount of NG increased from 39.53 to 47.36 from the day before surgery until the third day after surgery (p<0.01), and the percentage amount of lymphocytes decreased accordingly (p<0.05). There was also an increase in the concentration of eosinophil granulocytes from the day before to the day after surgery (p<0.05). The study demonstrated how surgical procedures leads to an increase in the acute phase protein CRP, and α-, β-and γ-Glob, reduction in Alb, and changes in the WBC profile in the days following surgery.

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Stress response and well-being after open, laparoscopic, and NOTES transgastric uterine horn resection in a randomized porcine model

Abstract: Despite the longer operating time, the transgastric NOTES approach seems to be less traumatic than open or laparoscopic uterine horn resection in this porcine model.

Cited by 7 publications

References 26 publications

Comparison of Inflammatory Response to Transgastric and Transcolonic NOTES

Comparison of Inflammatory Response to Transgastric and Transcolonic NOTES

The Length of Surgical Skin Incision in Postoperative Inflammatory Reaction

Acute phase response and hematology in pigs after cryptorchidism or inguinal hernia surgery

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