Cellular, hemostatic, and inflammatory parameters of the surgical stress response in pigs undergoing partial pericardectomy via open thoracotomy or thoracoscopy.
BACKGROUND
Thoracoscopy has been shown to reduce the inflammatory and immunologic response to surgical stress, as compared with corresponding open procedures in humans. The influence on the hemostatic system, however, has not been thoroughly evaluated. The current study aimed to compare the perioperative and immediate postoperative changes in cellular, hemostatic, and inflammatory parameters after a partial pericardectomy performed by either thoracoscopy or thoracotomy.


METHODS
For this study, 16 pigs were randomly assigned to have a partial pericardectomy performed thoracoscopically or by thoracotomy. Blood was collected intraoperatively, then 10 min, 3 h, and 6 h after surgery. Whole ethylenediaminetetraacetic acid (EDTA)-stabilized blood and plasma were examined for cellular, hemostatic, and inflammatory parameters, respectively, and thromboelastography (TEG) was performed on citrated whole blood.


RESULTS
No significant difference in any of the parameters measured was found between the two groups except for the TEG parameter R-time, which was significantly shorter in the thoracoscopic group 3 h postoperatively. In both groups, a significant postoperative state of hypercoagulability and increase in inflammatory parameters was found. Additionally, pig blood showed a high degree of hypercoagulability in preoperative measurements, as compared with other species.


CONCLUSIONS
Partial pericardectomy performed by thoracotomy or thoracoscopy in pigs produces a surgical stress response of equal magnitude, as measured by cellular, hemostatic, and inflammatory changes.
Palsgaard-Van Lue
A
A
Department of Small Animal Clinical Sciences, The Royal Veterinary and Agricultural University, Frederiksberg C, Denmark. apa@kvl.dk
Strøm
H
H
Lee
M H
MH
Jensen
A L
AL
Birck
M M
MM
Wiinberg
B
B
Kjelgaard-Hansen
M
M
Martinussen
T
T
Kristensen
A T
AT
D000818:Animals; D000991:Antithrombins / Q000378:metabolism; D001772:Blood Cell Count; D001780:Blood Coagulation Tests; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006487:Hemostasis; D007249:Inflammation / Q000209:etiology*; D008297:Male; D010492:Pericardiectomy / Q000009:adverse effects*; D013312:Stress, Physiological / Q000150:complications / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D013552:Swine; D013906:Thoracoscopy / Q000009:adverse effects*; D013908:Thoracotomy / Q000009:adverse effects*; D013916:Thrombelastography
D000991:Antithrombins; D005340:Fibrinogen; D002097:C-Reactive Protein