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

Authors

  • Marcelo Rezende Sao Paulo Federal University (UNIFESP); Gastroenterology Division
  • Edna Frasson de Souza Montero Sao Paulo Federal University (UNIFESP); Experimental Surgery Division
  • Reinaldo Salomao Sao Paulo Federal University (UNIFESP); Infectious and Parasitic Diseases Division
  • Milena Brunialti Sao Paulo Federal University (UNIFESP); Infectious and Parasitic Diseases Division
  • Rodrigo Rodrigues Sao Paulo Federal University (UNIFESP); Gastroenterology Division
  • Gustavo Gomes Sao Paulo Federal University (UNIFESP); Gastroenterology Division
  • Alice Della Libera Universidade de Sao Paulo (USP); College of Veterinary Medicine and Animal Science; Department of Internal Medicine
  • Angelo Ferrari Sao Paulo Federal University (UNIFESP); Gastroenterology Division
  • Ermelindo Della Libera Sao Paulo Federal University (UNIFESP); Gastroenterology Division

DOI:

https://doi.org/10.1590/clin.v68i11.77034

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 1β, 6 and 10 and tumor necrosis factor-α. 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 1β, interleukin 10 and tumor necrosis factor-α 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.

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Published

2013-11-01

Issue

Section

Basic Researches

How to Cite

Rezende, M., Montero, E. F. de S., Salomao, R., Brunialti, M., Rodrigues, R., Gomes, G., Libera, A. D., Ferrari, A., & Libera, E. D. (2013). Acute inflammatory response to transgastric natural orifice transluminal endoscopic surgery peritoneoscopy: An experimental study in swine. Clinics, 68(11), 1433-1439. https://doi.org/10.1590/clin.v68i11.77034