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Morphology of the murine peritoneum after pneumoperitoneum vs laparotomy.

机译：气腹与开腹后小鼠腹膜的形态学

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BACKGROUND: Although there have been studies of the effects of pneumoperitoneum on the peritoneal cavity, we still do not know whether the morphologic changes to the peritoneum are different for pneumoperitoneum vs laparotomy. Using scanning electron microscopy, we examined the murine peritoneum after pneumoperitoneum vs laparotomy and compared the changes. METHODS: Forty-five mice were anesthetized with diethyl ether and divided into seven groups. Pneumoperitoneum was established at 5 mmHg for 30 min with carbon dioxide (CO(2)) (n = 9), helium (n = 9), and air (n = 9). One group underwent laparotomy for 30 min (n = 9), and a control group underwent anesthesia only (n = 3). CO(2) pneumoperitoneum was further established at 10 mmHg for 30 min (n = 3) and at 5 mmHg for 60 min (n = 3). After the procedures, the peritoneum was resected from the mesenterium of the small intestine in each animal and examined by scanning electron microscope for morphologic changes of the mesothelial cells. RESULTS: Bulging up of the mesothelial cells was evident immediately after pneumoperitoneum, whereas detachment of the mesothelial cells was present immediately after laparotomy. Bulging up of the mesothelial cells was reduced at 24 h after CO(2) pneumoperitoneum and fully resolved at 72 h in all pneumoperitoneum groups, whereas the mesothelial cells remained detached at 72 h in the laparotomy group. Intercellular clefts were found immediately after helium pneumoperitoneum and were present at 24 h and 72 h after helium pneumoperitoneum, but they were not seen after air pneumoperitoneum and were only evident after CO(2) pneumoperitoneum at 10 mmHg. Depression of the mesothelial cell surface was observed when pneumoperitoneum lasted 60 min. CONCLUSION: Morphologic peritoneal alterations after pneumoperitoneum differed from those after laparotomy and were influenced by the type of gas, amount of pressure, and duration of insufflation. These peritoneal changes after pneumoperitoneum may be associated with a specific intraperitoneal tumor spread after laparoscopic cancer surgery.
机译：背景：尽管已经研究过气腹对腹膜腔的影响，但我们仍不知道气腹与开腹手术对腹膜的形态学变化是否有所不同。使用扫描电子显微镜，我们检查了气腹与开腹手术后的小鼠腹膜，并比较了变化。方法：45只小鼠用乙醚麻醉，分为7组。气腹以二氧化碳（CO（2））（n = 9），氦气（n = 9）和空气（n = 9）在5 mmHg下放置30分钟。一组接受剖腹手术30分钟（n = 9），对照组仅接受麻醉（n = 3）。 CO（2）气腹进一步建立在10毫米汞柱持续30分钟（n = 3）和5毫米汞柱持续60分钟（n = 3）。手术后，从每只动物的小肠的肠系膜切下腹膜，并通过扫描电子显微镜检查其间皮细胞的形态变化。结果：气腹后立即可见间皮细胞肿胀，而剖腹手术后立即出现间皮细胞脱离。在CO（2）气腹后24 h，间皮细胞的肿胀减少，并且在所有气腹组中，在72 h时完全溶解，而在剖腹手术组中，间皮细胞在72 h仍然分离。氦气气腹后立即发现细胞间裂，并在氦气气腹后24小时和72小时出现，但在空气气腹后未见，仅在10 mmHg的CO（2）气腹后可见。当气腹持续60分钟时，观察到间皮细胞表面的凹陷。结论：气腹后的腹膜形态学改变与剖腹手术后的不同，并且受气体种类，压力量和吹入持续时间的影响。气腹后的这些腹膜变化可能与腹腔镜癌手术后特定的腹膜内肿瘤扩散有关。

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