Does laparoscopy increase bacteremia and endotoxemia in a peritonitis model? |
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Authors: | C A Jacobi J Ordemann B Böhm H U Zieren H D Volk W Lorenz E Halle J M Müller |
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Institution: | (1) Department of Surgery, University of Berlin, Charité, Germany, DE;(2) Institute of Medical Immunology, University of Berlin, Charité, Germany, DE;(3) Institute of Theoretical Surgery, University of Marburg, Germany, DE;(4) Institute of Microbiology, University of Berlin, Charité, Germany, DE |
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Abstract: | Background: Laparoscopy is increasingly used in patients with intraabdominal bacterial infection although pneumoperitoneum may increase
bacteremia by elevated intraabdominal pressure.
Methods: The influence of laparotomy and laparoscopy on bacteremia, endotoxemia, and postoperative abscess formation was investigated
in a rat model. Rats received intraperitoneally a standardized fecal inoculum and underwent laparotomy (n= 20), or laparoscopy (n= 20), or no further manipulation in the control group (n= 20).
Results: Bacteremia and endotoxemia were higher after laparotomy and laparoscopy compared to the control group (p= 0.01) 1 h after intervention. One hour after intervention, aerobic and anaerobic bacterial species were detected in the
laparotomy group while only anaerobic bacteria were found in the other two groups. Although bacteremia and endotoxemia did
not differ among the three groups after 1 week, the mean number of intraperitoneal abscesses was significantly higher (p < 0.05) after laparotomy (n= 10) compared with laparoscopy (n= 6) and control group (n= 5).
Conclusion: Laparoscopy does not increase bacteremia and intraperitoneal abscess formation compared to laparotomy in an animal model
of peritonitis.
Received: 28 May 1996/Accepted: 25 July 1996 |
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Keywords: | : Laparoscopy — Peritonitis — Bacteremia — Endotoxemia |
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