Abstract
Development of a lethal model of peritonitis to assess the results of treating that peritonitis using videolaparoscopy and laparotomy. We developed a model of peritonitis in rats using cecal ligation (CLP) against a 2-mm diameter rigid mold and puncture. Two experiments were performed: determination of seven-day lethality; and analysis of white cell counts, blood cultures and cytokines (Interleukin-1 beta, Tumor Necrosis Factor-alpha and IL-6). The animals were divided into four groups: I--Sham surgery; II--CLP; III--CLP + Videolaparoscopy; and IV--CLP + Laparotomy . Seven-day lethality was 0% in group I, 80% in the group II (p<0.05), 60% in group III , and 20 % in group IV. There was a significant reduction in leukocyte counts and higher levels of serum IL-1 beta, TNF-alpha and IL-6 in the group II compared to controls. The percentages of positive blood cultures were higher after videolaparoscopic compared to laparotomic treatment. The experimental model provoked a lethal form of peritonitis and that videolaparoscopic treatment had more bacteraemia than laparotomy.
Highlights
Videolaparoscopy is frequently used for the surgical treatment of abdominal conditions of an inflammatory and infectious nature that have local manifestations[1]
We developed a model of peritonitis in rats using cecal ligation (CLP) against a 2-mm diameter rigid mold and puncture
The experimental model provoked a lethal form of peritonitis and that videolaparoscopic treatment had more bacteraemia than laparotomy
Summary
Videolaparoscopy is frequently used for the surgical treatment of abdominal conditions of an inflammatory and infectious nature that have local manifestations[1]. Patients submitted to laparoscopic repair of a perforated peptic ulcer presented higher cytokine levels when treated by videolaparoscopy, the increase was not significant[2]. In an animal model of long-term sepsis obtained by gastric perforation in pigs, a significant increase in the extent and severity of peritonitis and bacteremia was observed after treatment by videolaparoscopy[3]. Among the limitations of videolaparoscopic access for the treatment of peritonitis, the most significant is the possibility that high intra-abdominal pressure in the presence of pneumoperitoneum will induce bacterial translocation, along with the attendant bacteremia and death[5]. The aim of the present study was to develop a highly lethal model of diffuse bacterial peritonitis and to assess the results of treatment involving videolaparoscopic and laparotomic access
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