Skip to main content
Top
Published in: Surgical Endoscopy 5/2007

01-05-2007

Cellular, hemostatic, and inflammatory parameters of the surgical stress response in pigs undergoing partial pericardectomy via open thoracotomy or thoracoscopy

Authors: A. Palsgaard-Van Lue, H. Strøm, M. H. Lee, A. L. Jensen, M. M. Birck, B. Wiinberg, M. Kjelgaard-Hansen, T. Martinussen, A. T. Kristensen

Published in: Surgical Endoscopy | Issue 5/2007

Login to get access

Abstract

Background

Thoracoscopy has been shown to reduce the inflammatory and immunologic response to surgical stress, as compared with corresponding open procedures in humans. The influence on the hemostatic system, however, has not been thoroughly evaluated. The current study aimed to compare the perioperative and immediate postoperative changes in cellular, hemostatic, and inflammatory parameters after a partial pericardectomy performed by either thoracoscopy or thoracotomy.

Methods

For this study, 16 pigs were randomly assigned to have a partial pericardectomy performed thoracoscopically or by thoracotomy. Blood was collected intraoperatively, then 10 min, 3 h, and 6 h after surgery. Whole ethylenediaminetetraacetic acid (EDTA)-stabilized blood and plasma were examined for cellular, hemostatic, and inflammatory parameters, respectively, and thromboelastography (TEG) was performed on citrated whole blood.

Results

No significant difference in any of the parameters measured was found between the two groups except for the TEG parameter R-time, which was significantly shorter in the thoracoscopic group 3 h postoperatively. In both groups, a significant postoperative state of hypercoagulability and increase in inflammatory parameters was found. Additionally, pig blood showed a high degree of hypercoagulability in preoperative measurements, as compared with other species.

Conclusions

Partial pericardectomy performed by thoracotomy or thoracoscopy in pigs produces a surgical stress response of equal magnitude, as measured by cellular, hemostatic, and inflammatory changes.
Literature
1.
go back to reference Bessler M, Whelan RL, Halverson A, Treat MR, Nowygrod R (1994) Is immune function better preserved after laparoscopic versus open colon resection? Surg Endosc 8: 881–883PubMedCrossRef Bessler M, Whelan RL, Halverson A, Treat MR, Nowygrod R (1994) Is immune function better preserved after laparoscopic versus open colon resection? Surg Endosc 8: 881–883PubMedCrossRef
2.
go back to reference Burpee SE, Kurian M, Murakame Y, Benevides S, Gagner M (2002) The metabolic and immune response to laparoscopic versus open liver resection. Surg Endosc 16: 899–904PubMedCrossRef Burpee SE, Kurian M, Murakame Y, Benevides S, Gagner M (2002) The metabolic and immune response to laparoscopic versus open liver resection. Surg Endosc 16: 899–904PubMedCrossRef
3.
go back to reference Cermak J, Key NS, Bach RR, Balla J, Jacob HS, Vercellotti GM (1993) C-reactive protein induces human peripheral blood monocytes to synthesize tissue factor. Blood 82: 513–520PubMed Cermak J, Key NS, Bach RR, Balla J, Jacob HS, Vercellotti GM (1993) C-reactive protein induces human peripheral blood monocytes to synthesize tissue factor. Blood 82: 513–520PubMed
4.
go back to reference Collet D, Vitale GC, Reynolds M, Klar E, Cheadle WG (1995) Peritoneal host defenses are less impaired by laparoscopy than by open operation. Surg Endosc 9: 1059–1064PubMedCrossRef Collet D, Vitale GC, Reynolds M, Klar E, Cheadle WG (1995) Peritoneal host defenses are less impaired by laparoscopy than by open operation. Surg Endosc 9: 1059–1064PubMedCrossRef
5.
go back to reference Craig SR, Leaver HA, Yap PL, Pugh GC, Walker WS (2001) Acute phase responses following minimal access and conventional thoracic surgery. Eur J Cardiothorac Surg 20: 455–463PubMedCrossRef Craig SR, Leaver HA, Yap PL, Pugh GC, Walker WS (2001) Acute phase responses following minimal access and conventional thoracic surgery. Eur J Cardiothorac Surg 20: 455–463PubMedCrossRef
6.
go back to reference Dexter SPL, Griffith JP, Grant PJ, McMahon MJ (1996) Activation of coagulation and fibrinolysis in open and laparoscopic cholecystectomy. Surg Endosc 10: 1069–1074PubMedCrossRef Dexter SPL, Griffith JP, Grant PJ, McMahon MJ (1996) Activation of coagulation and fibrinolysis in open and laparoscopic cholecystectomy. Surg Endosc 10: 1069–1074PubMedCrossRef
7.
go back to reference Förster R, Storck M, Schafer JR, Honig E, Lang G, Liewald F (2002) Thoracoscopy versus thoracotomy: a prospective comparison of trauma and quality of life. Langenbecks Arch Surg 327: 32–36 Förster R, Storck M, Schafer JR, Honig E, Lang G, Liewald F (2002) Thoracoscopy versus thoracotomy: a prospective comparison of trauma and quality of life. Langenbecks Arch Surg 327: 32–36
8.
go back to reference Freyburger G, Dubreuil M, Audebert A, Labrouche S, Pistre JC, Molinari I, Dubecq F, Laville C, Villanove X (2001) Changes in haemostasis after laparoscopic surgery in gynaecology: contribution of the thrombin generation test. Haemostasis 31: 32–41PubMedCrossRef Freyburger G, Dubreuil M, Audebert A, Labrouche S, Pistre JC, Molinari I, Dubecq F, Laville C, Villanove X (2001) Changes in haemostasis after laparoscopic surgery in gynaecology: contribution of the thrombin generation test. Haemostasis 31: 32–41PubMedCrossRef
9.
go back to reference Gebhard FT, Becker HP, Gerngross H, Bruckner UB (1996) Reduced inflammatory response in minimal invasive surgery of pneumothorax. Arch Surg 131: 1079–1082PubMed Gebhard FT, Becker HP, Gerngross H, Bruckner UB (1996) Reduced inflammatory response in minimal invasive surgery of pneumothorax. Arch Surg 131: 1079–1082PubMed
10.
go back to reference Hamid J, Bancewicz J, Brown R, Ward C, Irving MH, Ford WL (1984) The significance of changes in blood lymphocyte populations following surgical operations. Clin Exp Immunol 56: 49–57PubMed Hamid J, Bancewicz J, Brown R, Ward C, Irving MH, Ford WL (1984) The significance of changes in blood lymphocyte populations following surgical operations. Clin Exp Immunol 56: 49–57PubMed
11.
go back to reference Hoffman M, Monroe DM (2001) A cell-based model of hemostasis. Thromb Haemost 85: 958–965PubMed Hoffman M, Monroe DM (2001) A cell-based model of hemostasis. Thromb Haemost 85: 958–965PubMed
12.
go back to reference Hunt BJ, Parratt RN, Segal HC, Sheikh S, Kallis P, Yacoub M (1998) Activation of coagulation and fibrinolysis during cardiothoracic operations. Ann Thorac Surg 65: 712–718PubMedCrossRef Hunt BJ, Parratt RN, Segal HC, Sheikh S, Kallis P, Yacoub M (1998) Activation of coagulation and fibrinolysis during cardiothoracic operations. Ann Thorac Surg 65: 712–718PubMedCrossRef
13.
go back to reference Jensen AL, Bomholt M, Moe L (2001) Preliminary evaluation of a particle-enhanced turbidimetric immunoassay (PETIA) for the determination of serum cystatin C-like immunoreactivity in dogs. Vet Clin Pathol 30: 86–90PubMed Jensen AL, Bomholt M, Moe L (2001) Preliminary evaluation of a particle-enhanced turbidimetric immunoassay (PETIA) for the determination of serum cystatin C-like immunoreactivity in dogs. Vet Clin Pathol 30: 86–90PubMed
14.
go back to reference Kalweit G, Huwer H, Volkmer I, Petzold T, Gams E (1996) Pulmonary embolism: a frequent cause of acute fatality after lung resection. Eur J Cardiothorac Surg 10: 242–246PubMedCrossRef Kalweit G, Huwer H, Volkmer I, Petzold T, Gams E (1996) Pulmonary embolism: a frequent cause of acute fatality after lung resection. Eur J Cardiothorac Surg 10: 242–246PubMedCrossRef
15.
go back to reference Kjelgaard-Hansen M, Martínez-Subiela S, Petersen HH, Jensen AL, Ceron JJ (2006) Evaluation and comparison of two immunoturbidimetric assays for the heterologous determination of porcine serum C-reactive protein. Vet J (in press). DOI 10.1016/j.tvjl.2006.01.012 Kjelgaard-Hansen M, Martínez-Subiela S, Petersen HH, Jensen AL, Ceron JJ (2006) Evaluation and comparison of two immunoturbidimetric assays for the heterologous determination of porcine serum C-reactive protein. Vet J (in press). DOI 10.1016/j.tvjl.2006.01.012
16.
go back to reference Leaver HA, Craig SR, Yap PL, Walker WS (2000) Lymphocyte responses following open and minimally invasive thoracic surgery. Eur J Clin Invest 30: 230–238PubMedCrossRef Leaver HA, Craig SR, Yap PL, Walker WS (2000) Lymphocyte responses following open and minimally invasive thoracic surgery. Eur J Clin Invest 30: 230–238PubMedCrossRef
17.
go back to reference Levi M, ten Cate H, van der Poll T (2002) Endothelium: interface between coagulation and inflammation. Crit Care Med 30: S220–S224PubMedCrossRef Levi M, ten Cate H, van der Poll T (2002) Endothelium: interface between coagulation and inflammation. Crit Care Med 30: S220–S224PubMedCrossRef
18.
go back to reference Levi M, van der PT, Buller HR (2004) Bidirectional relation between inflammation and coagulation. Circulation 109: 2698–2704 Levi M, van der PT, Buller HR (2004) Bidirectional relation between inflammation and coagulation. Circulation 109: 2698–2704
19.
go back to reference Lopez Y, Paramo JA, Valenti JR, Pardo F, Montes R, Rocha E (1997) Hemostatic markers in surgery: a different fibrinolytic activity may be of pathophysiological significance in orthopedic versus abdominal surgery. Int J Clin Lab Res 27: 233–237PubMed Lopez Y, Paramo JA, Valenti JR, Pardo F, Montes R, Rocha E (1997) Hemostatic markers in surgery: a different fibrinolytic activity may be of pathophysiological significance in orthopedic versus abdominal surgery. Int J Clin Lab Res 27: 233–237PubMed
21.
go back to reference Matsutani T, Onda M, Sasajima K, Miyashita M (1998) Glucocorticoid attenuates a decrease of antithrombin III following major surgery. J Surg Res 79:158–163PubMedCrossRef Matsutani T, Onda M, Sasajima K, Miyashita M (1998) Glucocorticoid attenuates a decrease of antithrombin III following major surgery. J Surg Res 79:158–163PubMedCrossRef
22.
go back to reference Ng CSH, Lee TW, Wan S, Wan IYP, Sihoe ADL, Arifi AA, Yim APC (2005) Thoracotomy is associated with significantly more profound suppression in lymphocytes and natural killer cells than video-assisted thoracic surgery following major lung resections for cancer. J Invest Surg 18: 81–88PubMedCrossRef Ng CSH, Lee TW, Wan S, Wan IYP, Sihoe ADL, Arifi AA, Yim APC (2005) Thoracotomy is associated with significantly more profound suppression in lymphocytes and natural killer cells than video-assisted thoracic surgery following major lung resections for cancer. J Invest Surg 18: 81–88PubMedCrossRef
23.
go back to reference Nguyen NT, Luketich JD, Schatz S, Tran Q, Ho HS, Schauer PR (1999) Effect of open and laparoscopic surgery on cellular immunity in a swine model. Surg Laparosc Endosc Percutan Tech 9: 176–180PubMedCrossRef Nguyen NT, Luketich JD, Schatz S, Tran Q, Ho HS, Schauer PR (1999) Effect of open and laparoscopic surgery on cellular immunity in a swine model. Surg Laparosc Endosc Percutan Tech 9: 176–180PubMedCrossRef
24.
go back to reference Nguyen NT, Luketich JD, Shurin MR, Schatz S, Tran Q, Ravid J, Schauer PR (1998) Coagulation modifications after laparoscopic and open cholecystectomy in a swine model. Surg Endosc 12: 973–978PubMedCrossRef Nguyen NT, Luketich JD, Shurin MR, Schatz S, Tran Q, Ravid J, Schauer PR (1998) Coagulation modifications after laparoscopic and open cholecystectomy in a swine model. Surg Endosc 12: 973–978PubMedCrossRef
25.
go back to reference Nguyen NT, Owings JT, Gosselin R, Pevec WC, Lee SJ, Goldman C, Wolfe BM (2001) Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass. Arch Surg 136: 909–915PubMedCrossRef Nguyen NT, Owings JT, Gosselin R, Pevec WC, Lee SJ, Goldman C, Wolfe BM (2001) Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass. Arch Surg 136: 909–915PubMedCrossRef
26.
go back to reference Rosenfeld BA, Nguyen ND, Sung I, Faraday N (1998) Neuroendocrine stress hormones do not recreate the postoperative hypercoagulable state. Anesth Analg 86: 640–645PubMedCrossRef Rosenfeld BA, Nguyen ND, Sung I, Faraday N (1998) Neuroendocrine stress hormones do not recreate the postoperative hypercoagulable state. Anesth Analg 86: 640–645PubMedCrossRef
27.
go back to reference Roussi J, Andre P, Samama M, Pignaud G, Bonneau M, Laporte A, Drouet L (1996) Platelet functions and haemostasis parameters in pigs: absence of side effects of a procedure of general anaesthesia. Thromb Res 81: 297–305PubMedCrossRef Roussi J, Andre P, Samama M, Pignaud G, Bonneau M, Laporte A, Drouet L (1996) Platelet functions and haemostasis parameters in pigs: absence of side effects of a procedure of general anaesthesia. Thromb Res 81: 297–305PubMedCrossRef
28.
go back to reference Siemens HJG, Brueckner S, Hagelberg S, Wagner T, Schmucker P (1999) Course of molecular hemostatic markers during and after different surgical procedures. J Clin Anesth 11: 622–629PubMedCrossRef Siemens HJG, Brueckner S, Hagelberg S, Wagner T, Schmucker P (1999) Course of molecular hemostatic markers during and after different surgical procedures. J Clin Anesth 11: 622–629PubMedCrossRef
29.
go back to reference Singer IO, Pringle S, Tait RC, Moore K, Alexander C, Hawthorn R (2000) Hysterectomy techniques and their effect on the blood markers of thrombogenicity. Gynaecol Endosc 9: 379–383CrossRef Singer IO, Pringle S, Tait RC, Moore K, Alexander C, Hawthorn R (2000) Hysterectomy techniques and their effect on the blood markers of thrombogenicity. Gynaecol Endosc 9: 379–383CrossRef
30.
go back to reference Toft P, Svendsen P, Tonnesen E, Rasmussen JW, Christensen NJ (1993) Redistribution of lymphocytes after major surgical stress. Acta Anaesthesiol Scand 37: 245–249PubMedCrossRef Toft P, Svendsen P, Tonnesen E, Rasmussen JW, Christensen NJ (1993) Redistribution of lymphocytes after major surgical stress. Acta Anaesthesiol Scand 37: 245–249PubMedCrossRef
31.
go back to reference Toft P, Tonnesen E, Helbo-Hansen HS, Lillevang ST, Rasmussen JW, Christensen NJ (1994) Redistribution of granulocytes in patients after major surgical stress. APMIS 102: 43–48PubMedCrossRef Toft P, Tonnesen E, Helbo-Hansen HS, Lillevang ST, Rasmussen JW, Christensen NJ (1994) Redistribution of granulocytes in patients after major surgical stress. APMIS 102: 43–48PubMedCrossRef
32.
go back to reference Vander Velpen G, Penninckx F, Kerremans R, Van Damme J, Arnout J (1994) Interleukin-6 and coagulation-fibrinolysis fluctuations after laparoscopic and conventional cholecystectomy. Surg Endosc 8: 1216–1220PubMedCrossRef Vander Velpen G, Penninckx F, Kerremans R, Van Damme J, Arnout J (1994) Interleukin-6 and coagulation-fibrinolysis fluctuations after laparoscopic and conventional cholecystectomy. Surg Endosc 8: 1216–1220PubMedCrossRef
33.
go back to reference Wiinberg B, Jensen AL, Rojkjaer R, Johansson P, Kjelgaard-Hansen M, Kristensen AT (2005) Validation of human recombinant tissue factor-activated thromboelastography on citrated whole blood from clinically healthy dogs. Vet Clin Pathol 34: 389–393PubMedCrossRef Wiinberg B, Jensen AL, Rojkjaer R, Johansson P, Kjelgaard-Hansen M, Kristensen AT (2005) Validation of human recombinant tissue factor-activated thromboelastography on citrated whole blood from clinically healthy dogs. Vet Clin Pathol 34: 389–393PubMedCrossRef
34.
go back to reference Ziomek S, Read RC, Tobler HG, Harrell JE, Gocio JC, Fink LM, Ranval TJ, Ferris EJ, Harshfield DL, Mcfarland DR, Schaefer RF, Purnell GL, Barnes RW, Cooper JD, Fry WA, Kafrouni G, Ohri SK (1993) Thromboembolism in patients undergoing thoracotomy. Ann Thorac Surg 56: 223–227PubMedCrossRef Ziomek S, Read RC, Tobler HG, Harrell JE, Gocio JC, Fink LM, Ranval TJ, Ferris EJ, Harshfield DL, Mcfarland DR, Schaefer RF, Purnell GL, Barnes RW, Cooper JD, Fry WA, Kafrouni G, Ohri SK (1993) Thromboembolism in patients undergoing thoracotomy. Ann Thorac Surg 56: 223–227PubMedCrossRef
Metadata
Title
Cellular, hemostatic, and inflammatory parameters of the surgical stress response in pigs undergoing partial pericardectomy via open thoracotomy or thoracoscopy
Authors
A. Palsgaard-Van Lue
H. Strøm
M. H. Lee
A. L. Jensen
M. M. Birck
B. Wiinberg
M. Kjelgaard-Hansen
T. Martinussen
A. T. Kristensen
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 5/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-9033-7

Other articles of this Issue 5/2007

Surgical Endoscopy 5/2007 Go to the issue