Laparoscopy vs minilaparotomy and full laparotomy preserves circulatory but not peritoneal and pulmonary immune responses
| Autor: | Birgit Teichmann, Benno M. Ure, Hiep T. Nguyen, N. K. Jesch, Heike Nave, J. F. Kuebler, Gertrud Vieten, Michael Bottlaender, Armin Braun |
|---|---|
| Přispěvatelé: | Publica |
| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment macrophage Abdominal cavity Nitric Oxide Monocytes Nitric oxide chemistry.chemical_compound Peritoneal cavity Superoxides Laparotomy Abdomen cytokine medicine Animals Postoperative Period Laparoscopy trauma response Lung Peritoneal Cavity medicine.diagnostic_test Interleukin-6 business.industry rat model General Medicine OX-6 Intercellular Adhesion Molecule-1 Rats Surgery medicine.anatomical_structure Cytokine chemistry Rats Inbred Lew Immune System Anesthesia Antibody Formation Antigens Surface Pediatrics Perinatology and Child Health Circulatory system Macrophages Peritoneal superoxide anion CD54 business Central venous catheter |
| Zdroj: | Journal of Pediatric Surgery. 41:1085-1092 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2006.02.002 |
| Popis: | Purpose Laparoscopy has been associated with lower inflammatory responses. However, it has been postulated that minilaparotomy, in contrast to full laparotomy, is equally minimally invasive. Objective The aim of this study was to investigate local, systemic, and distant organ immune responses after different surgical approaches to the abdominal cavity, such as minilaparotomy, full laparotomy, and laparoscopy, in a small animal model. Methods Male Lewis rats received a permanent central venous catheter and were randomized to 4 groups (n = 6 per group). The animals were subjected to anesthesia alone (control), minilaparotomy (1 cm), full laparotomy (7 cm), or laparoscopy for 60 minutes. Blood was collected via the central venous catheter before as well as 1 hour and 6 hours after the start of intervention. Peritoneal and bronchoalveolar lavages, as well as heart puncture, were performed after 24 hours. Results All surgical interventions led to a significant migration of polymorphonucleocytes into the abdominal cavity. Full laparotomy resulted in a significant increase in nitric oxide production by peritoneal macrophages as compared with control. Macrophage nitric oxide production after laparoscopy and minilaparotomy was not significantly different. A shift in the expression of OX-6 and CD54 was only detected after full laparotomy. Systemically, O 2 − release by circulating mononuclear cells was significantly increased after minilaparotomy and full laparotomy, but not after laparoscopy. The systemic levels of IL6 were significantly accelerated only after full laparotomy, with a maximum after 6 hours. In the lungs, function of alveolar macrophages was not altered in any group. Conclusions Any approach to the peritoneal cavity causes local inflammatory responses. Full laparotomy alters peritoneal macrophage functions more pronouncedly than does minilaparotomy or laparoscopy. Systemic inflammatory responses, such as free oxygen radical release, are significantly increased by both minilaparotomy and full laparotomy, whereas laparoscopy preserves systemic immune function. Our results may lead to further preference for the laparoscopic approach over minilaparotomy and full laparotomy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect