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World Journal of Surgery
Published in: World Journal of Surgery 4/2010

01-04-2010

Peritoneal Damage: The Inflammatory Response and Clinical Implications of the Neuro-Immuno-Humoral Axis

Authors: Tarik Sammour, Arman Kahokehr, Mattias Soop, Andrew G. Hill

Published in: World Journal of Surgery | Issue 4/2010

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Abstract

Background

The peritoneum is a bilayer serous membrane that lines the abdominal cavity. We present a review of peritoneal structure and physiology, with a focus on the peritoneal inflammatory response to surgical injury and its clinical implications.

Methods

We conducted a nonsystematic clinical review. A search of the Ovid MEDLINE database from 1950 through January 2009 was performed using the following search terms: peritoneum, adhesions, cytokine, inflammation, and surgery.

Results

The peritoneum is a metabolically active organ, responding to insult through a complex array of immunologic and inflammatory cascades. This response increases with the duration and extent of injury and is central to the concept of surgical stress, manifesting via a combination of systemic effects, and local neural pathways via the neuro-immuno-humoral axis. There may be a decreased systemic inflammatory response after minimally invasive surgery; however, it is unclear whether this is due to a reduced local peritoneal reaction.

Conclusions

Interventions that dampen the peritoneal response and/or block the neuro-immuno-humoral pathway should be further investigated as possible avenues of enhancing recovery after surgery, and reducing postoperative complications.
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Metadata
Title
Peritoneal Damage: The Inflammatory Response and Clinical Implications of the Neuro-Immuno-Humoral Axis
Authors
Tarik Sammour
Arman Kahokehr
Mattias Soop
Andrew G. Hill
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 4/2010
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-009-0382-y

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