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首页> 外文期刊>Surgical Endoscopy >Inflammatory response and bacterial dissemination after laparotomy and abdominal CO2 insufflation in a murine model of peritonitis.
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Inflammatory response and bacterial dissemination after laparotomy and abdominal CO2 insufflation in a murine model of peritonitis.

机译：在腹膜炎的小鼠模型中，剖腹手术和腹部CO2注入后的炎症反应和细菌传播。

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BACKGROUND: The immunologic repercussions due to cavity insufflation are the focus of great discussion. The aim of this study was to compare the inflammatory response and bacterial dissemination after laparotomy and abdominal CO2 insufflation in a murine model of peritonitis. METHODS: Swiss mice were inoculated intraperitoneally with 0.5 ml of a solution containing 1 x 10(8) colony-forming units (CFU)/ml of Escherichia coli and were divided into three groups as follow: control (anesthesia for 30 min), laparotomy (2.5-cm midline incision for 30 min), and CO2 pneumoperitoneum (CO2 cavity insufflation for 30 min). The number of leukocytes, CFU/ml counting, and the levels of interleukin (IL)-6, tumor necrosis factor-alpha (TNF-alpha), and IL-10 were evaluated in blood, peritoneal, and pleural fluid samples obtained at 90 min and 18 h after the procedures. RESULTS: The laparotomy group showed a greater bacterial dissemination to the blood, peritoneum, and pleural cavity and also greater neutrophil migrationto the peritoneal cavity compared to the CO2 insufflated and control groups. The 24-h mortality was also significantly higher in the laparotomy group. The IL-6 levels showed a precocious rise in all groups submitted to bacterial inoculation at the 90-min time point. At the 18-h time point, IL-6 levels in the peritoneum were significantly higher in the laparotomy group than in the control or CO2 insufflated groups. At the same time, TNF-alpha levels were higher in the laparotomy and CO2 insufflated groups than in controls; IL-10 levels showed no differences among the groups. CONCLUSIONS: Our results suggest that cavity insufflation with CO2 is a more effective method of access, inducing less bacterial dissemination and also a less intense inflammatory response. Cavity insufflation with CO2 may present a good option for the surgical treatment of patients with bacterial peritonitis.
机译：背景：由于腔内吹入引起的免疫反应是广泛讨论的焦点。这项研究的目的是比较在腹膜炎的小鼠模型中，剖腹手术和腹腔注入二氧化碳后的炎症反应和细菌传播。方法：将0.5 ml含1 x 10（8）集落形成单位（CFU）/ ml大肠杆菌的溶液腹膜内接种到瑞士小鼠，按以下方法分为三组：对照组（麻醉30分钟），剖腹术（2.5厘米中线切口30分钟）和CO2气腹（CO2腔注气30分钟）。在90时获得的血液，腹膜和胸膜液样品中评估白细胞数量，CFU / ml计数以及白细胞介素（IL）-6，肿瘤坏死因子-α（TNF-alpha）和IL-10的水平手术后至少18小时。结果：与CO 2吹气组和对照组相比，剖腹手术组显示出更多的细菌向血液，腹膜和胸膜腔扩散，并且中性粒细胞向腹膜腔的迁移也更大。剖腹手术组的24小时死亡率也明显更高。在90分钟的时间点接受细菌接种的所有组中，IL-6的水平均显示过早升高。在18小时的时间点，剖腹手术组的腹膜IL-6水平明显高于对照组或CO2吹入组。同时，剖腹手术和CO2吹入组的TNF-α水平高于对照组。 IL-10水平在各组之间无差异。结论：我们的结果表明，用二氧化碳注腔是一种更有效的进入方法，可减少细菌的传播，并减轻炎症反应。对于细菌性腹膜炎的患者，CO2腔内吹入术可能是一个很好的选择。

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