The uterine and tubal effects of laparoscopy in intra‐abdominal infection: a rat model

Abstract

ABSTRACTObjective To assess the severity of uterine and tubal infection and bacteraemia incidence in CO2 pneumoperitoneum vs. laparotomy, in a rat model of intra‐abdominal infection.Design Experimental study.Setting Experimental research laboratory at Başkent University.Subjects A total of 30 Wistar albino rats.Interventions Rats were given an intraperitoneal injection of 108 colony‐forming units of Escherichia coli and underwent laparotomy (n = 10), laparoscopy (n = 10) or no further manipulation (control group, n= 10) At 60 min after bacterial injection, a blood sample was collected from each rat, and the fallopian tubes and uterine horns were removed bilaterally. Each blood sample was cultured, and quantitative bacterial cultures were done for each organ.Main outcome measurements Bacterial counts in uterine horns, fallopian tubes and blood.Results The mean bacterial counts in the uterine and fallopian tissues from the laparoscopy group were higher than the counts in the laparotomy group, but this difference was not statistically significant. None of the uterine horns or fallopian tubes from the control animals showed bacterial growth. There was no statistically significant difference in bacteraemia incidence among the control, laparotomy and laparoscopy groups at 60 min after bacterial inoculation.Conclusions Uterine/tubal infection rates and bacteraemia incidence were similar in the laparoscopy and laparotomy groups. The exact mechanism is still unclear, but this finding indicates that, under both these conditions, bacterial biology is modified by mechanical bacterial clearance, peritoneal immunity, elevated intra‐abdominal pressure, CO2 atmosphere and exposure of the peritoneum to air. In addition to many advantages, laparoscopic surgery causes no more deleterious effects than laparotomy in cases of intra‐abdominal infection.