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Surgical Endoscopy

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01-09-2006

Inflammatory response and bacterial dissemination afterlaparotomy and abdominal CO₂ insufflation in a murine model of peritonitis

Authors: M. B. Pitombo, O. H. Lupi, R. N. Gomes, R. Amâncio, R. A. Refinetti, P. T. Bozza, H. C. Castro-Faria-Neto

Published in: Surgical Endoscopy | Issue 9/2006

Abstract

Background

The immunologic repercussions due to cavity insufflation are the focus of great discussion. The aim of this study was to compare the inflammatory response and bacterial dissemination after laparotomy and abdominal CO₂ insufflation in a murine model of peritonitis.

Methods

Swiss mice were inoculated intraperitoneally with 0.5 ml of a solution containing 1 × 10⁸ colony-forming units (CFU)/ml of Escherichia coli and were divided into three groups as follow: control (anesthesia for 30 min), laparotomy (2.5-cm midline incision for 30 min), and CO₂ pneumoperitoneum (CO₂ cavity insufflation for 30 min). The number of leukocytes, CFU/ml counting, and the levels of interleukin (IL)-6, tumor necrosis factor-α (TNF-α), and IL-10 were evaluated in blood, peritoneal, and pleural fluid samples obtained at 90 min and 18 h after the procedures.

Results

The laparotomy group showed a greater bacterial dissemination to the blood, peritoneum, and pleural cavity and also greater neutrophil migration to the peritoneal cavity compared to the CO₂ insufflated and control groups. The 24-h mortality was also significantly higher in the laparotomy group. The IL-6 levels showed a precocious rise in all groups submitted to bacterial inoculation at the 90-min time point. At the 18-h time point, IL-6 levels in the peritoneum were significantly higher in the laparotomy group than in the control or CO₂ insufflated groups. At the same time, TNF-α levels were higher in the laparotomy and CO₂ insufflated groups than in controls; IL-10 levels showed no differences among the groups.

Conclusions

Our results suggest that cavity insufflation with CO₂ is a more effective method of access, inducing less bacterial dissemination and also a less intense inflammatory response. Cavity insufflation with CO₂ may present a good option for the surgical treatment of patients with bacterial peritonitis.

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Title: Inflammatory response and bacterial dissemination afterlaparotomy and abdominal CO2 insufflation in a murine model of peritonitis
Authors: M. B. Pitombo
O. H. Lupi
R. N. Gomes
R. Amâncio
R. A. Refinetti
P. T. Bozza
H. C. Castro-Faria-Neto
Publication date: 01-09-2006
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 9/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-005-0117-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Inflammatory response and bacterial dissemination afterlaparotomy and abdominal CO₂ insufflation in a murine model of peritonitis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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