title: The influence on immunologic parameters during NOTES in a porcine survival model.
abstract: OBJECTIVE
  To analyze the effect of natural orifice transluminal endoscopic surgery (NOTES) on the survival of animals, by comparing the change of intraoperative and postoperative immunologic parameters of NOTES with laparoscopy.
  
  
  METHODS
  Twenty pigs were randomized to treatment with NOTES or standard laparoscopy. Each group underwent diagnostic peritoneoscopy by laparoscopy or NOTES in 90 minutes. Laboratory values, including interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α), were obtained at baseline, at intraoperative minute (IOM) 30, 60, and 90, and on postoperative day (POD) 1, 3, and 7.
  
  
  RESULTS
  All procedures were successfully completed and all animals (except one in the NOTES group) survived to POD 14. The level of IL-1 and TNF-α was not significantly different compared with the preoperative level of IL-1 and TNF-α in both groups at IOM 30 and 60. It increased significantly at IOM 90 and POD 1 and 3 in both groups. Although levels of both IL-1 and TNF-α were higher in the NOTES group compared with the other group, there was no significant difference between the groups. At POD 7, the level of IL-1 and TNF-α decreased to near-normal levels in both groups.
  
  
  CONCLUSIONS
  Although preliminary, the findings in this study do not currently support the assumption that NOTES is less invasive than laparoscopy. Further research is required to confirm these findings.
authors.affiliation: TianJin Mini-invasive Surgery Center, TianJin NanKai Hospital, TianJin, China.
authors.forename: ZhanGuo
authors.initials: Z
authors.lastname: Cao
authors.forename: MingFang
authors.initials: M
authors.lastname: Qin
authors.forename: Qing
authors.initials: Q
authors.lastname: Wang
authors.forename: FuSheng
authors.initials: F
authors.lastname: Zou
authors.forename: Ning
authors.initials: N
authors.lastname: Li
mesh_terms: D000818:Animals; D007375:Interleukin-1 / Q000097:blood*; D010535:Laparoscopy / Q000009:adverse effects*; D023421:Models, Animal; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects*; D011184:Postoperative Period; D016019:Survival Analysis; D013552:Swine; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha
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