PMID- 16247573
OWN - NLM
STAT- MEDLINE
DCOM- 20060921
LR  - 20181113
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 20
IP  - 2
DP  - 2006 Feb
TI  - Immediate peritoneal response to bacterial contamination during laparoscopic 
      surgery.
PG  - 316-21
AB  - BACKGROUND: Several studies have shown that laparoscopic surgery (LS) minimizes 
      surgical trauma and the immune function is better preserved. Another major 
      advantage of LS is the lower incidence of septic complications. However, several 
      in vitro studies have shown that CO(2) severely impairs macrophage physiology. In 
      theory, this would reduce the ability to respond to peritoneal contamination. 
      However, there is some controversy in view of the evidence of a better preserved 
      peritoneal response to sepsis. This study analyzed the early response of the 
      peritoneum to contamination in a CO(2) ambience. METHODS: A total of 192 CD-1 
      mice were distributed in three groups: group 1, laparotomy (LAP, n = 64); group 
      2, CO(2) laparoscopy (CO(2)-LC, n = 64); and group 3, wall lift laparoscopy 
      (WL-LC, n = 64). Mice in each group were randomized to receive 1 ml of 
      Escherichia coli suspension (1 x 10(4) colony-forming units/ml) or saline. 
      Peritoneal fluid was obtained at 1.5, 3, 6, and 12 h after surgery. Monocyte 
      chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), and prostaglandin E(2) 
      (PGE(2)) were measured. RESULTS: MCP-1 levels were significantly greater and 
      higher earlier in group 2 (CO(2)-LC) than in group 1 (LAP) (p < 0.007). 
      Simultaneously, the increment in the traction group (WL-LC, group 3) was 
      significantly higher (p < 0.002) than after laparotomy, with no differences in 
      group 2 (CO(2)-LC). When a contamination was added to the laparotomy subgroup, 
      there was a significant increase compared to the group without contamination (p < 
      0.5). MCP-1 modifications after contamination in the LAP group were statistically 
      significant and appeared later than in the WL-LC (p < 0.002) and CO(2)-LC groups 
      (p < 0.02). For IL-6, the three models presented a significant increase in the 
      noncontaminated groups. This occurred significantly later in the LAP group. 
      Simultaneously, the increase in IL-6 occurred earlier and was significantly 
      higher in the WL-LC group compared to the LAP group (p < 0.003), without 
      differences between CO(2)-LC and wall lift groups. Significant differences 
      between contaminated and noncontaminated subgroups were only observed in the 
      LC-CO(2) groups. When contaminated, the traction model sustained a higher and 
      earlier rise in IL-6 levels compared to the LAP and LC-CO(2) groups (p < 0.001). 
      For PGE(2), The three models showed a significant increase in PGE(2) levels in 
      the noncontaminated groups. However, there were no significant differences 
      between them. In the contaminated groups, there was no statistical difference 
      between the groups. CONCLUSION: Despite a transient impairment of the immediate 
      peritoneal response to a septic challenge, the degree of injury with LS is lower 
      than that with open surgery, and abdominal infection can therefore be better 
      controlled.
FAU - Targarona, E M
AU  - Targarona EM
AD  - Service of Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de 
      Barcelona, Barcelona, Spain. etargarona@lsp.santpau.es
FAU - Rodriguez, M
AU  - Rodriguez M
FAU - Camacho, M
AU  - Camacho M
FAU - Balague, C
AU  - Balague C
FAU - Gich, I
AU  - Gich I
FAU - Vila, L
AU  - Vila L
FAU - Trias, M
AU  - Trias M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20051024
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Ccl2 protein, mouse)
RN  - 0 (Chemokine CCL2)
RN  - 0 (Interleukin-6)
RN  - 142M471B3J (Carbon Dioxide)
RN  - K7Q1JQR04M (Dinoprostone)
SB  - IM
MH  - Abdomen/*surgery
MH  - Animals
MH  - Ascitic Fluid/metabolism
MH  - Carbon Dioxide
MH  - Chemokine CCL2/metabolism
MH  - Dinoprostone/metabolism
MH  - Escherichia coli Infections/*metabolism
MH  - Interleukin-6/metabolism
MH  - Laparoscopy/*adverse effects
MH  - Laparotomy/adverse effects
MH  - Mice
MH  - Mice, Inbred Strains
MH  - Peritoneum/*metabolism
MH  - Pneumoperitoneum, Artificial
MH  - Surgical Wound Infection/*metabolism
MH  - Time Factors
EDAT- 2005/10/26 09:00
MHDA- 2006/09/22 09:00
CRDT- 2005/10/26 09:00
PHST- 2005/05/14 00:00 [received]
PHST- 2005/08/31 00:00 [accepted]
PHST- 2005/10/26 09:00 [pubmed]
PHST- 2006/09/22 09:00 [medline]
PHST- 2005/10/26 09:00 [entrez]
AID - 10.1007/s00464-005-0367-3 [doi]
PST - ppublish
SO  - Surg Endosc. 2006 Feb;20(2):316-21. doi: 10.1007/s00464-005-0367-3. Epub 2005 Oct 
      24.