Comparison of pain and postoperative stress in dogs undergoing natural orifice transluminal endoscopic surgery, laparoscopic, and open oophorectomy
| Autor: | Peter D. Constable, Don J. Selzer, Stuart Sherman, Lynetta J. Freeman, Paul W. Snyder, Mohammad A. Al-Haddad, Emad Y. Rahmani, Michael V. Chiorean |
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| Rok vydání: | 2009 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty Surgical stress medicine.medical_treatment Ovariectomy Dogs Stress Physiological medicine Animals Radiology Nuclear Medicine and imaging Ovarian Diseases Prospective Studies Prospective cohort study Laparoscopy Pain Measurement Laparotomy Pain Postoperative biology medicine.diagnostic_test business.industry Interleukin-6 C-reactive protein Stomach Gastroenterology Oophorectomy Natural orifice transluminal endoscopic surgery Surgery Disease Models Animal Nociception C-Reactive Protein Anesthesia biology.protein Female business Follow-Up Studies |
| Zdroj: | Gastrointestinal endoscopy. 72(2) |
| ISSN: | 1097-6779 |
| Popis: | Background Few studies are available to compare the potential benefits of natural orifice transluminal endoscopic surgery (NOTES) approaches to traditional surgery. Objective To compare complications, surgical stress, and postoperative pain. Design Prospective study in dogs. Setting Research laboratory. Subjects Thirty dogs. Interventions Oophorectomy procedures were performed via NOTES and laparoscopic and traditional open surgery. Main Outcome Measurements Operative time, pain scores, systemic stress parameters (cortisol, glucose), surgical stress markers (interleukin 6, C-reactive protein), 3-day observation. Results Median operative times were 76, 44, and 35 minutes for the NOTES, laparoscopic, and open procedures, respectively, with the NOTES procedure being significantly longer than the other 2 procedures. All ovaries were completely excised, and all the animals survived without complications. The NOTES animals had greater increases in serum cortisol concentrations at 2 hours but no statistically significant differences in glucose concentrations compared with the other groups. Serum interleukin 6 and C-reactive protein concentrations were significantly increased at specific times compared with baseline in the NOTES group, but not in the open or laparoscopic surgery groups. Based on the cumulative pain score and nociceptive thresholds, the animals in the NOTES group demonstrated less evidence of pain. Limitations Small sample size, limited follow-up. Conclusions Although the NOTES oophorectomy procedures took approximately twice as long and there may be more evidence of tissue damage as judged by increases in serum cortisol and interleukin 6 concentrations, the dogs in the NOTES group had lower pain scores, especially when compared with animals undergoing open surgery. |
| Databáze: | OpenAIRE |
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