Abstract
To evaluate the efficacy of inducing peritonitis in rats through laparoscopic cecal ligation (CL), by means of an elastic band. Twelve Wistar rats were subjected to cecal ligated with an elastic band applied using a specially constructed applicator. In six of the animals (the CL group) the cecal sac was preserved intact whilst in the remaining animals (the CLP group) the sac was perforated with scissors. Clinical parameters, characteristics of the peritoneal cavity and cecum, and histological features of the cecal tissue were observed in all experimental animals 8 and 24 h after surgery. CLP animals exhibited at least one clinical sign of sepsis within the first 8 h of observation. The peritoneal liquid was observed to be clear in almost all members of the CLP. Polymorphonucleated cells were detected in the tunica serosa of the cecum of CLP animals. In contrast, all members of the CL group were alive after 24h, and of polymorphonucleated cells in the muscle layer of the cecal wall were observed. The presence of peritoneal liquid was not detected in CL animals. Although elastic ligation of the cecum was reproducible, puncture of the cecal sac was essential for induction of sepsis.
Highlights
A number of experimental models have been applied in the study of the physiopathology of peritonitis and abdominal sepsis
In order to expand our knowledge concerning induced peritonitis, and to improve our understanding of the physiopathology of abdominal sepsis, we have evaluated the efficacy of performing cecal ligation (CL) and cecal ligation and puncture (CLP) using a laparoscopic technique employing an elastic band rather than conventional silk thread to create the cecal sac
The six animals included in the CLP group exhibited clinical signs of peritonitis such as tachypnea and piloerection, all had evolved to stage 4 of infection within 8h of surgical induction, and five (83%) died within the 24 h observation period (Table 1)
Summary
A number of experimental models have been applied in the study of the physiopathology of peritonitis and abdominal sepsis. Ortega and Tang[9] state that technical difficulties may arise during laparoscopic procedures performed in the presence of infection which, depending on the intensity of the inflammatory process, can increase the risk of abdominal sepsis and lead to specific complications as explained by Serour[10] and Soler-Dorda G11. These authors prefer to be cautious concerning the application of laparoscopy in such situations and suggest that further research is required to reveal the severity of the problem[9,10, 11]
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