title: Reduced neutrophil sequestration in lung tissue after laparoscopic lavage in a rat peritonitis model.
abstract: Laparoscopy to treat abdominal infections is becoming more and more popular. The effects of the CO(2) pneumoperitoneum have not yet been completely clarified. In a rat peritonitis model, therefore, we investigated the influence of laparoscopic lavage in comparison with the conventional technique. A defined multibacterial fecal specimen was installed in the abdominal cavities of 80 rats. These animals were randomized to three groups: group 1 (n = 32), no intervention; group 2 (n = 24), conventional; group 3 (n = 24), laparoscopic lavage. At 1, 2, and 8 hours after the surgical intervention, animals were killed and autopsied. The main outcome measures were bacteremia, interleukin-6 (IL-6) in plasma and ascites, changes in the blood count, and myeloperoxidase (MPO) activity in lung, liver, kidney, and pancreas. Differences of bacteremia were not found. In the ascites a marked increase in IL-6 was observed after 8 hours, which was lower in the treatment groups than in the controls (p <0.025). MPO activity as a measure of the granulocytes present in the tissue showed significant changes only in lung tissue. Two hours after the surgical intervention, the MPO in the lung in the laparoscopy group was significantly lower than that in the controls and the laparotomy group. In conclusion, conventional and laparoscopic lavage reduce inflammation. In this model, laparoscopic lavage with a CO(2) pneumoperitoneum appeared to have no negative influence on the inflammatory reaction during the early postoperative phase. Reduced neutrophil sequestration in lung tissue following laparoscopic lavage reflects the lower level of trauma caused by laparoscopy.
authors.affiliation: Department of Surgery, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Pross
authors.forename: Rene
authors.initials: R
authors.lastname: Mantke
authors.forename: Dagmar
authors.initials: D
authors.lastname: Kunz
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinheckel
authors.forename: Walter
authors.initials: W
authors.lastname: Halangk
authors.forename: H
authors.initials: H
authors.lastname: Lippert
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Schulz
mesh_terms: D000818:Animals; D001201:Ascites / Q000097:blood* / Q000209:etiology*; D001202:Ascitic Fluid / Q000737:chemistry; D016470:Bacteremia / Q000097:blood* / Q000209:etiology*; D001772:Blood Cell Count; D001998:Bronchopulmonary Sequestration / Q000097:blood* / Q000209:etiology*; D004195:Disease Models, Animal; D015850:Interleukin-6 / Q000097:blood*; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D008168:Lung / Q000737:chemistry*; D008297:Male; D010533:Peritoneal Lavage / Q000009:adverse effects*; D010538:Peritonitis / Q000097:blood* / Q000601:surgery*; D009195:Peroxidase / Q000032:analysis; D051381:Rats; D017208:Rats, Wistar; D013997:Time Factors
chemical_list: D015850:Interleukin-6; D009195:Peroxidase