Evaluation of the effects of laparotomy and laparoscopy on the immune system in intra-abdominal sepsis--a review.
This review portrays the most common experimental models of intra-abdominal sepsis. Additionally, it outlines the facts that distinguish laparotomy from laparoscopy, in respect to the immune response, when comparing these two techniques in experimental models of intra-abdominal sepsis. It describes the consequences of pneumoperitoneum and trauma produced by laparoscopy or laparotomy, respectively, on bacterial translocation and immunity. Furthermore, we report the few efforts that have been made in clinical settings, where surgeons have attempted to utilize laparoscopy as a therapeutic module when treating peritonitis or sepsis of abdominal origin. Certainly there is a need for more research in order to fortify the role of pneumoperitoneum in sepsis of abdominal origin. It seems that minimally invasive surgery will inevitably gain acceptance by surgeons, as evidence points that by inflicting less trauma the healing response is expected to be more efficient, especially in septic patients.
Karantonis
Fotios-Filippos
FF
Laboratory for Experimental Surgery and Surgical Research N.S Xristeas, University of Athens Medical School, Greece. fkarant@med.uoa.gr
Nikiteas
Nikolaos
N
Perrea
Despina
D
Vlachou
Antonia
A
Giamarellos-Bourboulis
Evangelos J
EJ
Tsigris
Christos
C
Kostakis
Alkiviadis
A
D034841:Abdominal Cavity; D000818:Animals; D004195:Disease Models, Animal; D004927:Escherichia coli Infections / Q000276:immunology / Q000601:surgery; D005243:Feces / Q000382:microbiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007813:Laparotomy / Q000009:adverse effects; D008070:Lipopolysaccharides / Q000633:toxicity; D010538:Peritonitis / Q000209:etiology / Q000276:immunology / Q000601:surgery; D011028:Pneumoperitoneum, Artificial; D018805:Sepsis / Q000209:etiology / Q000276:immunology* / Q000601:surgery*
D008070:Lipopolysaccharides