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Effects of carbon dioxide pneumoperitoneum on the inflammatory response and bacterial translocation in intraabdominal
Gang Wang1, Rongde Wu, Feng Guo
1Department of Pediatric Surgery, Provincial Hospital affiliated with Shandong University , Jinan, Shandong, China .
Background:
This study evaluated the effect of CO2 pneumoperitoneum on intraabdominal infection and bacterial translocation in intraabdominal infection.
Materials And Methods:
Escherichia coli and Bacteroides fragilis were injected separately into the abdominal cavities of 30 New Zealand white rabbits to establish two animal models of intraabdominal infection. Each model was divided into a laparotomy group, a pneumoperitoneum group, and a control group. Before and 1, 2, 4, and 7 days after surgery, blood and peritoneal fluids were obtained to determine bacterial culture and serum interleukin-6, tumor necrosis factor-α, and C-reactive protein levels by enzyme-linked immunosorbent assay. The total number of white blood cells (WBCs) was measured. Seven days after surgery, the animals were sacrificed and dissected, and liver, kidney, and spleen tissues were obtained for bacterial culture.
Results:
In the two bacterial models, incidence rates of bacteremia were higher in the laparotomy and pneumoperitoneum groups than in the control group. However, there were no significant differences between the laparotomy and pneumoperitoneum groups. Visceral bacterial translocation was detected in each group with no significant difference among the three groups. The change of inflammatory factors in the E. coli group and the B. fragilis group was nearly the same: the inflammatory factor levels and WBC counts in the laparotomy group were significantly higher than in the pneumoperitoneum group. The inflammatory factor levels and WBC counts in the pneumoperitoneum group increased slowly and were restored to normal quickly.
Conclusions:
In the intraabdominal infection animal model of the pneumoperitoneum group, the inflammatory response was weaker and the immune function was less affected and restored to normal more quickly than in the laparotomy group. The incidence rate of visceral bacterial translocation was not higher than that in the laparotomy group.
Insights
Carbon dioxide pneumoperitoneum in intraabdominal infection models showed a weaker inflammatory response and faster immune recovery compared to laparotomy. Bacterial translocation rates were similar between the two surgical methods.
Area of Science:
- Surgical Innovation
- Infectious Disease Research
- Immunology
Background:
- Intraabdominal infection poses significant clinical challenges.
- The impact of CO2 pneumoperitoneum on infection and bacterial translocation requires detailed investigation.
Purpose of the Study:
- To evaluate the effects of CO2 pneumoperitoneum versus laparotomy on intraabdominal infection and bacterial translocation in an animal model.
- To compare the inflammatory response and immune recovery between the two surgical approaches.
Main Methods:
- Established intraabdominal infection models in rabbits using Escherichia coli and Bacteroides fragilis.
- Compared laparotomy, pneumoperitoneum, and control groups.
- Monitored bacterial cultures, inflammatory markers (IL-6, TNF-α, CRP), and white blood cell counts pre- and post-surgery.
- Assessed bacterial translocation in visceral organs.
Main Results:
- Bacteremia rates were elevated in both laparotomy and pneumoperitoneum groups compared to controls, with no significant difference between surgical groups.
- Visceral bacterial translocation occurred in all groups without significant variation.
- The laparotomy group exhibited significantly higher inflammatory factor levels and WBC counts than the pneumoperitoneum group.
- Pneumoperitoneum group showed a slower increase and quicker normalization of inflammatory markers and WBC counts.
Conclusions:
- CO2 pneumoperitoneum resulted in a less pronounced inflammatory response and quicker immune recovery compared to laparotomy in intraabdominal infection models.
- The incidence of visceral bacterial translocation was comparable between pneumoperitoneum and laparotomy groups.
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