title: Absence of intestinal inflammation and postoperative ileus in a mouse model of laparoscopic surgery.
abstract: BACKGROUND
  Postoperative ileus (POI) is characterized by impaired gastrointestinal motility resulting from intestinal handling-associated inflammation. The introduction of laparoscopic surgery has dramatically reduced the duration of POI. However, it remains unclear to what extent this results in a reduction of intestinal inflammation. The aim of the present study is to compare the degree of intestinal inflammation and gastrointestinal transit following laparoscopic surgery and open abdominal surgery.
  
  
  METHODS
  Mice were subjected to laparoscopic surgery or laparotomy alone or, in combination with standardized intestinal manipulation of the small bowel (IM). Gastrointestinal transit and intestinal inflammation were assessed 24 h after surgery by the number of myeloperoxidase (MPO) positive cells and the level of cytokine expression. The recovery time and the degree of inflammation were also analyzed in patients subjected to colectomy under open conditions (laparotomy) or laparoscopic conditions.
  
  
  RESULTS
  Mice undergoing IM by laparotomy (open IM), but not by laparoscopy (Lap IM) developed a significant delay in gastrointestinal transit compared to laparotomy or laparoscopy alone. In addition, there was significant intestinal inflammation only after open IM. Similarly, cytokine levels in peritoneal lavage fluid were lower while recovery time was faster in patients subjected to colectomy under laparoscopic conditions compared to open colectomy.
  
  
  CONCLUSIONS
  Our data confirms that intestinal inflammation is underlying the delayed gastrointestinal transit observed after open surgery. Most importantly, we demonstrate that intestinal inflammation under laparoscopic conditions is significantly lower compared to open surgery, most likely explaining the faster recovery following laparoscopic surgery.
authors: Translational Research in GastroIntestinal Disorders (TARGID) and Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.
authors: Pedro J
authors: PJ
authors: Gomez-Pinilla
authors: Maria M
authors: MM
authors: Binda
authors: Ann
authors: A
authors: Lissens
authors: Martina
authors: M
authors: Di Giovangiulio
authors: Sjoerd H
authors: SH
authors: van Bree
authors: Andrea
authors: A
authors: Nemethova
authors: Nathalie
authors: N
authors: Stakenborg
authors: Giovanna
authors: G
authors: Farro
authors: Goele
authors: G
authors: Bosmans
authors: Gianluca
authors: G
authors: Matteoli
authors: Jan
authors: J
authors: Deprest
authors: Guy E
authors: GE
authors: Boeckxstaens
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004751:Enteritis / Q000209:etiology* / Q000378:metabolism; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D045823:Ileus / Q000209:etiology*; D007378:Interleukins / Q000378:metabolism; D007579:Jejunal Diseases / Q000209:etiology* / Q000378:metabolism; D010535:Laparoscopy / Q000009:adverse effects*; D051379:Mice; D008810:Mice, Inbred C57BL
chemical_list: D007378:Interleukins
keywords: colectomy; inflammation; intestinal manipulation; laparoscopic surgery; mouse model; open surgery; postoperative ileus