Laparoscopic diagnosis and treatment of aortic vascular prosthetic graft infections in a porcine model.
OBJECTIVE
To study the feasibility and efficacy of experimental laparoscopy in the diagnosis of aortic graft infection in pigs.


METHODS
Eight pigs had an aortic tube graft implanted and inoculated with either 5 x 10(4) or 10(6) CFU of Staphylococcus aureus ATCC 29213. Laparoscopy was performed after a median of 20 days with debridement and sampling for bacterial culture. Thereafter, the grafts were locally soaked in rifampicin and postoperatively, the pigs received rifampicin and ciprofloxacin orally for two weeks and were then sacrificed.


RESULTS
All pigs developed graft infection. One pig died from severe clostridial septicaemia before laparoscopy could be performed. The remaining pigs had all samples for bacterial culture taken by laparoscopy from the inflamed tissue. The temperature dropped significantly after laparoscopy, and no macroscopic signs of infection presented at autopsy. However, only culture from one pig was without S. aureus at autopsy.


CONCLUSIONS
Laparoscopy is a potential diagnostic tool for aortic graft infection and also affords the opportunity to carry out bacteriological sampling and local antibiotic treatment. The efficacy of laparoscopic treatment needs further evaluation.
Gao
H
H
Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, 8800 Viborg, Denmark.
Lund
L
L
Prag
J
J
Sandermann
J
J
Lindholt
J S
JS
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001011:Aorta / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D002939:Ciprofloxacin / Q000627:therapeutic use; D003646:Debridement; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D005240:Feasibility Studies; D005260:Female; D010535:Laparoscopy; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D012293:Rifampin / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D013552:Swine; D013997:Time Factors
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D012293:Rifampin