Intraperitoneal hyperthermic perfusion may induce bacterial translocation.
OBJECTIVE
Intraperitoneal hyperthermic perfusion (IPHP) has been used widely in oncologic practice. Hyperthermia is known to decrease the interstitial pressure. Also intraperitoneal hyperthermia may alter the intestinal mucosal barrier and the intestinal bacterial flora. These changes may lead to bacterial translocation (BT). To the best of our knowledge, there is no data about the possible role of IPHP on BT.


METHODS
Fifty-one rats were divided into two groups. Group I (n=36) received IPHP by heated isotonic salt solution at a temperature of of 43.0 degrees C and group II (n=15) received intraperitoneal normothermic lavage by isotonic salt solution at 37.0 degrees C. Each group was divided into three subgroups which were sacrificed at 1st (Ia, IIa), 3rd (Ib, IIb) and 7th (Ic, IIc) days. Mesenteric lymph nodes (MLN), spleen and liver were sampled and cecal aspirates were obtained. The presence of viable bacteria in samples was noted. Cecal bacterial population levels (CBPL) were reported as colony forming units (CFU). Groups were compared in terms of BT and CBPL.


RESULTS
BT was not detected in the Ia (IPHP, 1st day) and IIa,b,c (all control groups). However, statistically significant BT was observed in group Ib and Ic (83.3% and 66.6%, respectively) in comparison to control group (p<0.01). Also there was positive correlation between CBPL and BT.


CONCLUSIONS
Intraperitoneal hyperthermia causes remarkable BT. This may explain septic complications after IPHP. Further studies are necessary to better understand the effects of IPHP on the pathophysiology of BT.
Bozer
Mikdat
M
Department of Surgery and Section of Surgical Oncology, Ankara University School of Medicine, Turkey.
Türkçapar
Nuran
N
Bayar
Sancar
S
Kocaoglu
Hilmi
H
D000818:Animals; D018988:Bacterial Translocation; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects*; D004926:Escherichia coli / Q000302:isolation & purification / Q000502:physiology*; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D007263:Infusions, Parenteral; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008099:Liver / Q000382:microbiology; D008198:Lymph Nodes / Q000382:microbiology; D008297:Male; D008643:Mesentery / Q000382:microbiology; D051381:Rats; D017208:Rats, Wistar; D013154:Spleen / Q000382:microbiology
D007552:Isotonic Solutions