PMID- 18813979
OWN - NLM
STAT- MEDLINE
DCOM- 20090423
LR  - 20181113
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 23
IP  - 1
DP  - 2009 Jan
TI  - Immunologic parameters during NOTES compared with laparoscopy in a randomized 
      blinded porcine trial.
PG  - 178-81
LID - 10.1007/s00464-008-0162-z [doi]
AB  - BACKGROUND: It remains unclear if the natural orifice translumenal endoscopic 
      surgery (NOTES) technique is less invasive than laparoscopy. Serum interleukins 
      and peritoneal cellular response have been utilized to support the immunologic 
      difference between open and laparoscopic surgery. We hypothesized that there 
      would be no difference between cytokine levels during NOTES or laparoscopic 
      peritoneoscopy. METHODS: Twelve pigs were assigned to NOTES or standard 
      laparoscopy with permuted block randomization. Each group underwent 90 min of 
      diagnostic peritoneoscopy using CO(2) for laparoscopy and air for NOTES 
      pneumoperitoneum. Blood draws were obtained at baseline, at procedure end, and on 
      postoperative days (POD) 1, 2, and 7. Quantification of cytokines (IL-1b and 
      TNF-alpha) was performed with a Duo Set Porcine enzyme-linked immunosorbent assay 
      (ELISA). Laboratory results were captured by a technician blinded to the research 
      question, and data analysis was performed by an investigator blinded to the 
      procedure using t-test and repeated measures linear model. The study was approved 
      by the institutional animal care and use committee (IACUC). RESULTS: All 
      procedures were successfully completed. One NOTES animal succumbed to hemorrhagic 
      gastritis (day 3). All other animals thrived to POD 14, with no gross infections 
      at necropsy. Animals undergoing laparoscopy had lower mean arterial pH than NOTES 
      animals (p < 0.001). Serum and intraperitoneal white blood cell (WBC) counts were 
      similar between the groups. Mean interleukin-1b levels at baseline, at the end of 
      the procedure and at 48 h did not differ (0.50 and 0.31; p = 0.65). TNF-alpha 
      levels did not differ at baseline or procedure end but increased in the NOTES 
      group on POD 1, persisting to POD 7. Tumor necrosis factor-alpha (TNF-alpha) 
      decreased in the laparoscopy group (p = 0.005). CONCLUSION: Cytokines and WBC did 
      not differ between laparoscopic and NOTES groups during the initial 24 h. These 
      findings do not currently support the assumption that NOTES is less invasive than 
      laparoscopy. The late TNF-alpha elevation contradicts other studies and requires 
      further examination.
FAU - Bingener, Juliane
AU  - Bingener J
AD  - Department of Surgery, Mayo Clinic Rochester, 200 First Street SW, Rochester, MN 
      55905, USA. bingenercasey.juliane@mayo.edu
FAU - Krishnegowda, Naveen K
AU  - Krishnegowda NK
FAU - Michalek, Joel E
AU  - Michalek JE
LA  - eng
PT  - Journal Article
DEP - 20080924
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Interleukin-1beta)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 142M471B3J (Carbon Dioxide)
SB  - IM
CIN - Endoscopy. 2010 Jan;42(1):73-6. PMID: 20066594
MH  - Animals
MH  - Carbon Dioxide
MH  - *Endoscopy, Digestive System
MH  - Female
MH  - Gastrostomy
MH  - Interleukin-1beta/*blood
MH  - *Laparoscopy
MH  - *Pneumoperitoneum, Artificial
MH  - Pressure
MH  - Swine
MH  - Tumor Necrosis Factor-alpha/*blood
EDAT- 2008/09/25 09:00
MHDA- 2009/04/25 09:00
CRDT- 2008/09/25 09:00
PHST- 2008/05/05 00:00 [received]
PHST- 2008/07/24 00:00 [accepted]
PHST- 2008/07/08 00:00 [revised]
PHST- 2008/09/25 09:00 [pubmed]
PHST- 2009/04/25 09:00 [medline]
PHST- 2008/09/25 09:00 [entrez]
AID - 10.1007/s00464-008-0162-z [doi]
PST - ppublish
SO  - Surg Endosc. 2009 Jan;23(1):178-81. doi: 10.1007/s00464-008-0162-z. Epub 2008 Sep 
      24.