Acute inflammatory response to transgastric natural orifice transluminal endoscopic surgery peritoneoscopy: An experimental study in swine

Acute inflammatory response to transgastric natural orifice transluminal endoscopic surgery peritoneoscopy: An experimental study in swine

Author Rezende, Marcelo Autor UNIFESP Google Scholar
Montero, Edna Frasson de Souza Autor UNIFESP Google Scholar
Salomão, Reinaldo Autor UNIFESP Google Scholar
Brunialti, Milena Autor UNIFESP Google Scholar
Rodrigues, Rodrigo Autor UNIFESP Google Scholar
Gomes, Gustavo Autor UNIFESP Google Scholar
Della Libera, Alice Google Scholar
Ferrari, Angelo Paulo Autor UNIFESP Google Scholar
Della Libera, Ermelindo Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Abstract OBJECTIVE: To investigate the impact of transgastric peritoneal access on plasma biomarkers of acute inflammatory response in comparison to laparoscopy.METHODS: This was a prospective and comparative study in a porcine model. Transgastric peritoneal access performed by natural orifice transluminal endoscopic surgery was compared with laparoscopy. Laparotomy and sham groups were used as positive and negative controls, respectively. Thirty-four pigs were assigned to receive transgastric natural orifice transluminal endoscopic surgery (n = 12), laparoscopy (n = 8), laparotomy (n = 8) or a sham procedure involving only anesthesia (n = 6). in the natural orifice transluminal endoscopic surgery group, peritoneoscopy was performed with a gastroscope via transgastric access. Blood samples were collected at baseline and 1, 3, 6, 9 and 24 h after the surgical procedure for measurement of interleukins 1 beta, 6 and 10 and tumor necrosis factor-alpha. A complete blood count was performed, and C-reactive protein levels were measured at baseline and at 24 h.RESULTS: All surgical and endoscopic procedures were performed without major complications. Peritoneal cavity inventory showed no signs of peritonitis in any animal. Interleukin 1 beta, interleukin 10 and tumor necrosis factor-alpha levels were below the threshold of detection. the mean level of interleukin 6 was statistically significantly higher in the laparotomy group than in the other groups (p < 0.05), with no significant differences among the sham, laparoscopy and natural orifice transluminal endoscopic surgery groups (p > 0.05). C-reactive protein analysis indicated significant increases in all groups, with no differences among the groups. Complete blood count analysis showed no differences among the groups.CONCLUSIONS: Based on the observed interleukin 6 patterns, the systemic inflammatory response resulting from transgastric peritoneal access by natural orifice transluminal endoscopic surgery is similar in intensity to the response that occurs after laparoscopy.
Keywords Natural Orifice Endoscopic Surgery
Laparoscopy
Acute-Phase Reaction
Surgical Procedures
Minimally Invasive
Endoscopy
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Date 2013-01-01
Published in Clinics. São Paulo: Hospital Clinicas, Univ São Paulo, v. 68, n. 11, p. 1433-1439, 2013.
ISSN 1807-5932 (Sherpa/Romeo, impact factor)
Publisher Hospital Clinicas, Univ São Paulo
Extent 1433-1439
Origin http://dx.doi.org/10.6061/clinics/2013(11)09
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000329984600009
SciELO ID S1807-59322013001101433 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/35764

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