nach oben

Erschienen in:

01.11.2012

Evaluation of the clinical and inflammatory responses in exclusively NOTES transvaginal cholecystectomy versus laparoscopic routes: an experimental study in swine

verfasst von: Josiel P. Vieira, Marcelo M. Linhares, Elesiário M. Caetano Jr., Rita M. A. Moura, Vitor Asseituno, Rogério Fuzyi, Manoel J. B. Girão, José M. Ruano, Alberto Goldenberg, Gaspar de Jesus L. Filho, Délcio Matos

Erschienen in: Surgical Endoscopy | Ausgabe 11/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

The aim of this study was to evaluate the clinical and inflammatory responses to surgical trauma caused by the natural orifice transluminal endoscopic surgery (NOTES) transvaginal endoscopic procedure compared with those of the laparoscopic route.

Methods

Twenty-one female swine were divided into three groups of seven animals and subjected to cholecystectomy using laparoscopic, laparotomic, and exclusively NOTES transvaginal routes. A group of five animals served as a control. The animals were monitored during surgery to evaluate anesthetic/surgical time and the presence of complications, which were evaluated after surgery with respect to roaming time, feeding, and the presence of clinical occourrence Measurements of TNF-α, IL-1β, IL-6, CRP, IFN-γ were obtained before and after surgery, on the second and seventh postoperative days, and when the animals were killed and necropsied.

Results

All procedures were successfully completed as proposed in each group. Perioperative complications consisted of only gallbladder perforation and hepatic bleeding. The anesthetic/surgical time was longer in the NOTES vaginal group (p < 0.001). The postanesthetic recovery time, roaming, nutrition, and clinical evolution were similar in all groups. IL-1β and IL-6 were undetectable in all groups. Levels of TNF-α, CRP, and IFN-γ were similar among the groups. However, the evolution of the inflammatory process, measured as the difference between the peak dose and the basal dose of IFN-γ, was lower in the NOTES group than in the laparotomy group. In the necropsy findings, only adhesions were found, with no difference among the groups.

Conclusions

The entirely NOTES transvaginal cholecystectomy was feasible and safe. The surgical time was greater for the NOTES vaginal route. The inflammatory response was similar among the groups based on the levels of CRP and IFN-γ. However, the evolution of the inflammatory process seems to have been shorter in the vaginal NOTES group than in the laparotomy group as demonstrated by the difference between the peak and basal doses of IFN-γ.

Heinrich PC, Castell JV, Andus T (1990) Interleukin-6 and the acute phase response. Biochem J 265(3):621–636PubMed

Sheeran P, Hall GM (1997) Cytokines in anaesthesia. Br J Anaesth 78(2):201–219PubMed

Novitsky YW, Litwin DE, Callery MP (2004) The net immunologic advantage of laparoscopic surgery. Surg Endosc 18(10):1411–1419PubMed

Buttenschoen K, Fathimani K, Buttenschoen DC (2010) Effect of major abdominal surgery on the host immune response to infection. Curr Opin Infect Dis 23(3):259–267PubMed

Kamei K, Nimura Y, Nagino M, Aono K, Nakashima I (2002) Surgical stress reduces mortality from endotoxin shock. Langenbecks Arch Surg 386(7):512–517PubMed

Delgado S, Lacy AM, Filella X, Castells A, Garcia-Valdecasas JC, Pique JM, Momblan D, Visa J (2001) Acute phase response in laparoscopic and open colectomy in colon cancer: randomized study. Dis Colon Rectum 44(5):638–646PubMed

Weissman C (1990) The metabolic response to stress: an overview and update. Anesthesiology 73(2):308–327PubMed

Davies MG, Hagen PO (1997) Systemic inflammatory response syndrome. Br J Surg 84(7):920–935PubMed

Corrigan M, Cahill RA, Redmond HP (2007) The immunomodulatory effects of laparoscopic surgery. Surg Laparosc Endosc Percutan Tech 17(4):256–261PubMed

10.

Menger MD, Vollmar B (2004) Surgical trauma: hyperinflammation versus immunosuppression? Langenbecks Arch Surg 389(6):475–484PubMed

11.

Ordemann J, Jacobi CA, Schwenk W, Stosslein R, Muller JM (2001) Cellular and humoral inflammatory response after laparoscopic and conventional colorectal resections. Surg Endosc 15(6):600–608PubMed

12.

Maruszynski M, Pojda Z (1995) Interleukin 6 (IL-6) levels in the monitoring of surgical trauma. A comparison of serum IL-6 concentrations in patients treated by cholecystectomy via laparotomy or laparoscopy. Surg Endosc 9(8):882–885PubMed

13.

Harmon GD, Senagore AJ, Kilbride MJ, Warzynski MJ (1994) Interleukin-6 response to laparoscopic and open colectomy. Dis Colon Rectum 37(8):754–759PubMed

14.

Vittimberga FJ Jr, Foley DP, Meyers WC, Callery MP (1998) Laparoscopic surgery and the systemic immune response. Ann Surg 227(3):326–334PubMed

15.

Hackam DJ, Rotstein OD (1998) Host response to laparoscopic surgery: mechanisms and clinical correlates. Can J Surg 41(2):103–111PubMed

16.

Rattner D, Kalloo A (2006) ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery. Surg Endosc 2:329–333

17.

Zorron R, Maggioni LC, Pombo L, Oliveira AL, Carvalho GL, Filgueiras M (2008) NOTES transvaginal cholecystectomy: preliminary clinical application. Surg Endosc 22(2):542–547PubMed

18.

Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, Magee CA, Kantsevoy SV (2004) Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 60(1):114–117PubMed

19.

Niu J, Song W, Yan M, Fan W, Niu W, Liu E, Peng C, Lin P, Li P, Khan AQ (2010) Transvaginal laparoscopically assisted endoscopic cholecystectomy: preliminary clinical results for a series of 43 cases in China. Surg Endosc 25(4):128

20.

Zornig C, Mofid H, Emmermann A, Alm M, von Waldenfels HA, Felixmuller C (2008) Scarless cholecystectomy with combined transvaginal and transumbilical approach in a series of 20 patients. Surg Endosc 22(6):1427–1429PubMed

21.

McGee MF, Schomisch SJ, Marks JM, Delaney CP, Jin J, Williams C, Chak A, Matteson DT, Andrews J, Ponsky JL (2008) Late phase TNF-alpha depression in natural orifice translumenal endoscopic surgery (NOTES) peritoneoscopy. Surgery 143(3):318–328PubMed

22.

Wagh MS, Merrifield BF, Thompson CC (2006) Survival studies after endoscopic transgastric oophorectomy and tubectomy in a porcine model. Gastrointest Endosc 63(3):473–478PubMed

23.

Kantsevoy SV, Jagannath SB, Niiyama H, Isakovich NV, Chung SS, Cotton PB, Gostout CJ, Hawes RH, Pasricha PJ, Kalloo AN (2007) A novel safe approach to the peritoneal cavity for per-oral transgastric endoscopic procedures. Gastrointest Endosc 65(3):497–500PubMed

24.

Jagannath SB, Kantsevoy SV, Vaughn CA, Chung SS, Cotton PB, Gostout CJ, Hawes RH, Pasricha PJ, Scorpio DG, Magee CA, Pipitone LJ, Kalloo AN (2005) Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in a porcine model. Gastrointest Endosc 61(3):449–453PubMed

25.

Harrell AG, Heniford BT (2005) Minimally invasive abdominal surgery: lux et veritas past, present, and future. Am J Surg 190(2):239–243PubMed

26.

Bessler M, Stevens PD, Milone L, Parikh M, Fowler D (2007) Transvaginal laparoscopically assisted endoscopic cholecystectomy: a hybrid approach to natural orifice surgery. Gastrointest Endosc 66(6):1243–1245PubMed

27.

Marescaux J, Dallemagne B, Perretta S, Wattiez A, Mutter D, Coumaros D (2007) Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 142(9):823–826PubMed

28.

Targarona EM, Maldonado EM, Marzol JA, Marinello F (2010) Natural orifice transluminal endoscopic surgery: The transvaginal route moving forward from cholecystectomy. World J Gastrointest Surg 2(6):179–186PubMed

29.

Palanivelu C, Rajan PS, Rangarajan M, Parthasarathi R, Senthilnathan P, Prasad M (2008) Transvaginal endoscopic appendectomy in humans: a unique approach to NOTES–world’s first report. Surg Endosc 22(5):1343–1347PubMed

30.

Noguera JF, Dolz C, Cuadrado A, Olea JM, Vilella A (2008) Transvaginal liver resection (NOTES) combined with minilaparoscopy. Rev Esp Enferm Dig 100(7):411–415PubMed

31.

Forgione A, Maggioni D, Sansonna F, Ferrari C, Di Lernia S, Citterio D, Magistro C, Frigerio L, Pugliese R (2008) Transvaginal endoscopic cholecystectomy in human beings: preliminary results. J Laparoendosc Adv Surg Tech A 18(3):345–351PubMed

32.

Dolz C, Noguera JF, Martin A, Vilella A, Cuadrado A (2007) Transvaginal cholecystectomy (NOTES) combined with minilaparoscopy. Rev Esp Enferm Dig 99(12):698–702PubMed

33.

Decarli L, Zorron R, Branco A, Lima FC, Tang M, Pioneer SR, Zanin I Jr, Schulte AA, Bigolin AV, Gagner M (2008) Natural orifice translumenal endoscopic surgery (NOTES) transvaginal cholecystectomy in a morbidly obese patient. Obes Surg 18(7):886–889PubMed

34.

Salinas G, Saavedra L, Agurto H, Quispe R, Ramirez E, Grande J, Sanchez V, Tamayo J, Malaga D, Marks JM (2010) Early experience in human hybrid transgastric and transvaginal endoscopic cholecystectomy. Surg Endosc 24(5):1092–1098PubMed

35.

Ramos AC, Galvão Neto MP, Campos JM, Moura EGH, Galvão PA, Galvão M, Mottin CC, Marchesini JCD (2011) Colecistectomia transgástrica e transvaginal CETON/NOTES. Endosc Cirurg Obes 42:417–426

36.

Pugliese R, Forgione A, Sansonna F, Ferrari GC, Di Lernia S, Magistro C (2010) Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases. Langenbecks Arch Surg 395(3):241–245PubMed

37.

Noguera J, Dolz C, Cuadrado A, Olea J, Vilella A, Morales R (2009) Hybrid transvaginal cholecystectomy, NOTES, and minilaparoscopy: analysis of a prospective clinical series. Surg Endosc 23(4):876–881PubMed

38.

Horgan S, Cullen JP, Talamini MA, Mintz Y, Ferreres A, Jacobsen GR, Sandler B, Bosia J, Savides T, Easter DW, Savu MK, Ramamoorthy SL, Whitcomb E, Agarwal S, Lukacz E, Dominguez G, Ferraina P (2009) Natural orifice surgery: initial clinical experience. Surg Endosc 23(7):1512–1518PubMed

39.

Cuadrado-Garcia A, Noguera JF, Olea-Martinez JM, Morales R, Dolz C, Lozano L, Vicens JC, Pujol JJ (2011) Hybrid natural orifice transluminal endoscopic cholecystectomy: prospective human series. Surg Endosc 25(1):19–22PubMed

40.

Zorron R, Palanivelu C, Galvao Neto MP, Ramos A, Salinas G, Burghardt J, Decarli L, Henrique Sousa L, Forgione A, Pugliese R, Branco AJ, Balashanmugan TS, Boza C, Corcione F, D’Avila Avila F, Arturo Gomez N, Galvao Ribeiro PA, Martins S, Filgueiras M, Gellert K, Wood Branco A, Kondo W, Inacio Sanseverino J, de Sousa JA, Saavedra L, Ramirez E, Campos J, Sivakumar K, Rajan PS, Jategaonkar PA, Ranagrajan M, Parthasarathi R, Senthilnathan P, Prasad M, Cuccurullo D, Muller V (2010) International multicenter trial on clinical natural orifice surgery–NOTES IMTN study: preliminary results of 362 patients. Surg Innov 17(2):142–158PubMed

41.

Zornig C, Mofid H, Siemssen L, Emmermann A, Alm M, von Waldenfels HA, Felixmuller C (2009) Transvaginal NOTES hybrid cholecystectomy: feasibility results in 68 cases with mid-term follow-up. Endoscopy 41(5):391–394PubMed

42.

Linke GR, Tarantino I, Hoetzel R, Warschkow R, Lange J, Lachat R, Zerz A (2010) Transvaginal rigid-hybrid NOTES cholecystectomy: evaluation in routine clinical practice. Endoscopy 42(7):571–575PubMed

43.

Lehmann KS, Ritz JP, Wibmer A, Gellert K, Zornig C, Burghardt J, Busing M, Runkel N, Kohlhaw K, Albrecht R, Kirchner TG, Arlt G, Mall JW, Butters M, Bulian DR, Bretschneider J, Holmer C, Buhr HJ (2010) The German registry for natural orifice translumenal endoscopic surgery: report of the first 551 patients. Ann Surg 252(2):263–270PubMed

44.

Hensel M, Schernikau U, Schmidt A, Arlt G (2010) Comparison between transvaginal and laparoscopic cholecystectomy - a retrospective case-control study. Zentralbl Chir 137(1):48–54PubMed

45.

Zornig C, Siemssen L, Emmermann A, Alm M, von Waldenfels HA, Felixmuller C, Mofid H (2010) NOTES cholecystectomy: matched-pair analysis comparing the transvaginal hybrid and conventional laparoscopic techniques in a series of 216 patients. Surg Endosc 25(6):1822–1826PubMed

46.

Zornig C, Mofid H, Siemssen L, Wenck CH (2010) Transvaginal access for NOTES. Chirurg 81(5):426–430PubMed

47.

Bingener J, Krishnegowda NK, Michalek JE (2009) Immunologic parameters during NOTES compared with laparoscopy in a randomized blinded porcine trial. Surg Endosc 23(1):178–181PubMed

48.

Fan JK, Tong DK, Ho DW, Luk J, Law WL, Law S (2009) Systemic inflammatory response after natural orifice translumenal surgery: transvaginal cholecystectomy in a porcine model. JSLS 13(1):9–13PubMed

49.

Freeman LJ, Rahmani EY, Al Haddad M, Sherman S, Chiorean MV, Selzer DJ, Snyder PW, Constable PD (2010) Comparison of pain and postoperative stress in dogs undergoing natural orifice transluminal endoscopic surgery, laparoscopic, and open oophorectomy. Gastrointest Endosc 72(2):373–380PubMed

50.

Suzuki K, Yasuda K, Kawaguchi K, Yoshizumi F, Inomata M, Shiraishi N, Kitano S (2010) Cardiopulmonary and immunologic effects of transvaginal natural-orifice transluminal endoscopic surgery cholecystectomy compared with laparoscopic cholecystectomy in a porcine survival model. Gastrointest Endosc 72(6):1241–1248PubMed

51.

Trunzo JA, McGee MF, Cavazzola LT, Schomisch S, Nikfarjam M, Bailey J, Mishra T, Poulose BK, Lee YJ, Ponsky JL, Markes JM (2010) Peritoneal inflammatory response of natural orifice translumenal endoscopic surgery (NOTES) versus laparoscopy with carbon dioxide and air pneumoperitoneum. Surg Endosc 24(7):1727–1736PubMed

52.

53.

Shih SP, Kantsevoy SV, Kalloo AN, Magno P, Giday SA, Ko CW, Isakovich NV, Meireles O, Hanly EJ, Marohn MR (2007) Hybrid minimally invasive surgery–a bridge between laparoscopic and translumenal surgery. Surg Endosc 21(8):1450–1453PubMed

54.

Bessler M, Gumbs AA, Milone L, Evanko JC, Stevens P, Fowler D (2010) Video. Pure natural orifice transluminal endoscopic surgery (NOTES) cholecystectomy. Surg Endosc 24(9):2316–2317PubMed

55.

de Sousa LH, de Sousa JA, Sousa Filho LH, de Sousa MM, de Sousa VM, de Sousa AP, Zorron R (2009) Totally NOTES (T-NOTES) transvaginal cholecystectomy using two endoscopes: preliminary report. Surg Endosc 23(11):2550–2555PubMed

56.

Gumbs AA, Fowler D, Milone L, Evanko JC, Ude AO, Stevens P, Bessler M (2009) Transvaginal natural orifice translumenal endoscopic surgery cholecystectomy: early evolution of the technique. Ann Surg 249(6):908–912PubMed

57.

Scott DJ, Tang SJ, Fernandez R, Bergs R, Goova MT, Zeltser I, Kehdy FJ, Cadeddu JA (2007) Completely transvaginal NOTES cholecystectomy using magnetically anchored instruments. Surg Endosc 21(12):2308–2316PubMed

58.

Delvaux G, Devroey P, De Waele B, Willems G (2007) Transvaginal removal of gallbladders with large stones after laparoscopic cholecystectomy. Surg Laparosc Endosc 3(4):307–309

59.

Wilson JI, Dogiparthi KK, Hebblethwaite N, Clarke MD (2007) Laparoscopic right hemicolectomy with posterior colpotomy for transvaginal specimen retrieval. Colorectal Dis 9(7):662PubMed

60.

Freeman LJ, Rahmani EY, Sherman S, Chiorean MV, Selzer DJ, Constable PD, Snyder PW (2009) Oophorectomy by natural orifice transluminal endoscopic surgery: feasibility study in dogs. Gastrointest Endosc 69(7):1321–1332PubMed

61.

von Delius S, Huber W, Feussner H, Wilhelm D, Karagianni A, Henke J, Preissel A, Schneider A, Schmid RM, Meining A (2007) Effect of pneumoperitoneum on hemodynamics and inspiratory pressures during natural orifice transluminal endoscopic surgery (NOTES): an experimental, controlled study in an acute porcine model. Endoscopy 39(10):854–861

62.

Hanly EJ, Aurora AA, Shih SP, Fuentes JM, Marohn MR, De Maio A, Talamini MA (2007) Peritoneal acidosis mediates immunoprotection in laparoscopic surgery. Surgery 142(3):357–364PubMed

63.

Rotstein OD (2001) Peritoneal host defenses: modulation by carbon dioxide insufflation. Surg Infect (Larchmt) 2(2):163–168

64.

McGee MF, Rosen MJ, Marks J, Chak A, Onders R, Faulx A, Ignagni A, Schomisch S, Ponsky J (2007) A reliable method for monitoring intraabdominal pressure during natural orifice translumenal endoscopic surgery. Surg Endosc 21(4):672–676PubMed

65.

Bergman S, Nutting A, Feldman LS, Vassiliou MC, Andrew CG, Demyttenaere S, Woo D, Carli F, Jutras L, Buthieu J, Stanbridge DD, Fried GM (2006) Elucidating the relationship between cardiac preload and renal perfusion under pneumoperitoneum. Surg Endosc 20(5):794–800PubMed

66.

Meireles O, Kantsevoy SV, Kalloo AN, Jagannath SB, Giday SA, Magno P, Shih SP, Hanly EJ, Ko CW, Beitler DM, Marohn MR (2007) Comparison of intraabdominal pressures using the gastroscope and laparoscope for transgastric surgery. Surg Endosc 21(6):998–1001PubMed

67.

Ryou M, Thompson CC (2009) Magnetic retraction in natural-orifice transluminal endoscopic surgery (NOTES): addressing the problem of traction and countertraction. Endoscopy 41(2):143–148PubMed

68.

Asakuma M, Perretta S, Allemann P, Cahill R, Con SA, Solano C, Pasupathy S, Mutter D, Dallemagne B, Marescaux J (2009) Challenges and lessons learned from NOTES cholecystectomy initial experience: a stepwise approach from the laboratory to clinical application. J Hepatobiliary Pancreat Surg 16(3):249–254PubMed

69.

Horgan S, Mintz Y, Jacobsen GR, Sandler BJ, Cullen JP, Spivack A, Easter DW, Chock A, Savu MK, Ramamoorthy S, Bosia J, Agarwal S, Lukacz E, Whitcomb E, Savides T, Talamini MA (2009) Video. NOTES: transvaginal cholecystectomy with assisting articulating instruments. Surg Endosc 23(8):1900PubMed

70.

Bingener J, Michalek J, Winston J, Van Sickle K, Haines V, Schwesinger W (2008) Randomized blinded trial comparing the cardiopulmonary effects of NOTES with standard laparoscopy in a porcine survival model. Surg Endosc 22(6):1430–1434PubMed

71.

AGSE/SAGES (2006) ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery White Paper October 2005. Gastrointest Endosc 63(2):199–203

72.

Park PO, Long GL, Bergstrom M, Cunningham C, Vakharia OJ, Bakos GJ, Bally KR, Rothstein RI, Swain CP (2010) A randomized comparison of a new flexible bipolar hemostasis forceps designed principally for NOTES versus a conventional surgical laparoscopic bipolar forceps for intra-abdominal vessel sealing in a porcine model. Gastrointest Endosc 71(4):835–841PubMed

73.

Mohiuddin K, Nizami S, Fitzgibbons RJ Jr, Watson P, Memon B, Memon MA (2006) Predicting iatrogenic gall bladder perforation during laparoscopic cholecystectomy: a multivariate logistic regression analysis of risk factors. ANZ J Surg 76(3):130–132PubMed

74.

Woodfield JC, Rodgers M, Windsor JA (2004) Peritoneal gallstones following laparoscopic cholecystectomy: incidence, complications, and management. Surg Endosc 18(8):1200–1207PubMed

75.

Bergman S, Melvin WS (2008) Natural orifice translumenal endoscopic surgery. Surg Clin North Am 88(5):1131–1148 viiiPubMed

76.

Pauli EM, Moyer MT, Haluck RS, Mathew A (2008) Self-approximating transluminal access technique for natural orifice transluminal endoscopic surgery: a porcine survival study (with video). Gastrointest Endosc 67(4):690–697PubMed

77.

Merrifield BF, Wagh MS, Thompson CC (2006) Peroral transgastric organ resection: a feasibility study in pigs. Gastrointest Endosc 63(4):693–697PubMed

78.

Lomanto D, Chua HC, Myat MM, So J, Shabbir A, Ho L (2009) Microbiological contamination during transgastric and transvaginal endoscopic techniques. J Laparoendosc Adv Surg Tech A 19(4):465–469PubMed

79.

Dubcenco E, Assumpcao L, Dray X, Gabrielson KL, Ruben DS, Pipitone LJ, Donatelli G, Krishnamurty DM, Baker JP, Marohn MR, Kalloo AN (2009) Adhesion formation after peritoneoscopy with liver biopsy in a survival porcine model: comparison of laparotomy, laparoscopy, and transgastric natural orifice transluminal endoscopic surgery (NOTES). Endoscopy 41(11):971–978PubMed

80.

Wichmann MW, Huttl TP, Winter H, Spelsberg F, Angele MK, Heiss MM, Jauch KW (2005) Immunological effects of laparoscopic vs open colorectal surgery: a prospective clinical study. Arch Surg 140(7):692–697PubMed

81.

Ueo H, Honda M, Adachi M, Inoue H, Nakashima H, Arinaga S, Akiyoshi T (1994) Minimal increase in serum interleukin-6 levels during laparoscopic cholecystectomy. Am J Surg 168(4):358–360PubMed

82.

Schietroma M, Carlei F, Lezoche E, Agnifili A, Enang GN, Mattucci S, Minervini S, Lygidakis NJ (2001) Evaluation of immune response in patients after open or laparoscopic cholecystectomy. Hepatogastroenterology 48(39):642–646PubMed

83.

Reith HB, Kaman S, Mittelkotter O, Kilic Y, Kozuschek W (1997) Cytokine activation in patients undergoing open or laparoscopic cholecystectomy. Int Surg 82(4):389–393PubMed

84.

Kristiansson M, Saraste L, Soop M, Sundqvist KG, Thorne A (1999) Diminished interleukin-6 and C-reactive protein responses to laparoscopic versus open cholecystectomy. Acta Anaesthesiol Scand 43(2):146–152PubMed

85.

Karayiannakis AJ, Makri GG, Mantzioka A, Karousos D, Karatzas G (1997) Systemic stress response after laparoscopic or open cholecystectomy: a randomized trial. Br J Surg 84(4):467–471PubMed

86.

Grande M, Tucci GF, Adorisio O, Barini A, Rulli F, Neri A, Franchi F, Farinon AM (2002) Systemic acute-phase response after laparoscopic and open cholecystectomy. Surg Endosc 16(2):313–316PubMed

87.

Glaser F, Sannwald GA, Buhr HJ, Kuntz C, Mayer H, Klee F, Herfarth C (1995) General stress response to conventional and laparoscopic cholecystectomy. Ann Surg 221(4):372–380PubMed

88.

Chaudhary D, Verma GR, Gupta R, Bose SM, Ganguly NK (1999) Comparative evaluation of the inflammatory mediators in patients undergoing laparoscopic versus conventional cholecystectomy. Aust N Z J Surg 69(5):369–372PubMed

89.

Baumann H, Gauldie J (1994) The acute phase response. Immunol Today 15(2):74–80PubMed

90.

Baigrie RJ, Lamont PM, Kwiatkowski D, Dallman MJ, Morris PJ (1992) Systemic cytokine response after major surgery. Br J Surg 79(8):757–760PubMed

91.

Biffl WL, Moore EE, Moore FA, Peterson VM (1996) Interleukin-6 in the injured patient. Marker of injury or mediator of inflammation? Ann Surg 224(5):647–664PubMed

92.

Malik E, Buchweitz O, Muller-Steinhardt M, Kressin P, Meyhofer-Malik A, Diedrich K (2001) Prospective evaluation of the systemic immune response following abdominal, vaginal, and laparoscopically assisted vaginal hysterectomy. Surg Endosc 15(5):463–466PubMed

93.

Cruickshank AM, Fraser WD, Burns HJ, Van Damme J, Shenkin A (1990) Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci (Lond) 79(2):161–165

94.

Schwenk W, Jacobi C, Mansmann U, Bohm B, Muller JM (2000) Inflammatory response after laparoscopic and conventional colorectal resections - results of a prospective randomized trial. Langenbecks Arch Surg 385(1):2–9PubMed

95.

Halevy A, Lin G, Gold-Deutsch R, Lavi R, Negri M, Evans S, Cotariu D, Sackier JM (1995) Comparison of serum C-reactive protein concentrations for laparoscopic versus open cholecystectomy. Surg Endosc 9(3):280–282PubMed

96.

Bocci V (1991) Interleukins. Clinical pharmacokinetics and practical implications. Clin Pharmacokinet 21(4):274–284PubMed

97.

Cho JM, LaPorta AJ, Clark JR, Schofield MJ, Hammond SL, Mallory PL (1994) Response of serum cytokines in patients undergoing laparoscopic cholecystectomy. Surg Endosc 8(12):1380–1383PubMed

98.

Leung KL, Lai PB, Ho RL, Meng WC, Yiu RY, Lee JF, Lau WY (2000) Systemic cytokine response after laparoscopic-assisted resection of rectosigmoid carcinoma: A prospective randomized trial. Ann Surg 231(4):506–511PubMed

99.

Li P, Xu Q, Ji Z, Gao Y, Zhang X, Duan Y, Guo Z, Zheng B, Guo X, Wu X (2005) Comparison of surgical stress between laparoscopic and open appendectomy in children. J Pediatr Surg 40(8):1279–1283PubMed

100.

Nguyen NT, Goldman CD, Ho HS, Gosselin RC, Singh A, Wolfe BM (2002) Systemic stress response after laparoscopic and open gastric bypass. J Am Coll Surg 194(5):557–566PubMed

101.

Roumen RM, van Meurs PA, Kuypers HH, Kraak WA, Sauerwein RW (1992) Serum interleukin-6 and C reactive protein responses in patients after laparoscopic or conventional cholecystectomy. Eur J Surg 158(10):541–544PubMed

102.

Schietroma M, Carlei F, Franchi L, Mazzotta C, Sozio A, Lygidakis NJ, Amicucci G (2004) A comparison of serum interleukin-6 concentrations in patients treated by cholecystectomy via laparotomy or laparoscopy. Hepatogastroenterology 51(60):1595–1599PubMed

103.

Boo M (2008) Public cord blood banking may play an important role in the emergence of unrelated transplant in developing countries. Transfusion 48(2):207–208PubMed

104.

Decker D, Schondorf M, Bidlingmaier F, Hirner A, von Ruecker AA (1996) Surgical stress induces a shift in the type-1/type-2 T-helper cell balance, suggesting down-regulation of cell-mediated and up-regulation of antibody-mediated immunity commensurate to the trauma. Surgery 119(3):316–325PubMed

105.

Brune IB, Wilke W, Hensler T, Holzmann B, Siewert JR (1999) Downregulation of T helper type 1 immune response and altered pro-inflammatory and anti-inflammatory T cell cytokine balance following conventional but not laparoscopic surgery. Am J Surg 177(1):55–60PubMed

106.

Khashab MA, Kalloo AN (2010) Natural orifice translumenal endoscopic surgery. Curr Opin Gastroenterol 26(5):471–477PubMed

107.

Whang SH, Thaler K (2010) Natural orifice transluminal endoscopic surgery: where are we going? World J Gastroenterol 16(35):4371–4373PubMed

Titel: Evaluation of the clinical and inflammatory responses in exclusively NOTES transvaginal cholecystectomy versus laparoscopic routes: an experimental study in swine
verfasst von: Josiel P. Vieira
Marcelo M. Linhares
Elesiário M. Caetano Jr.
Rita M. A. Moura
Vitor Asseituno
Rogério Fuzyi
Manoel J. B. Girão
José M. Ruano
Alberto Goldenberg
Gaspar de Jesus L. Filho
Délcio Matos
Publikationsdatum: 01.11.2012
Verlag: Springer-Verlag
Erschienen in: Surgical Endoscopy / Ausgabe 11/2012
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-012-2329-x

Neu im Fachgebiet Chirurgie

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Evaluation of the clinical and inflammatory responses in exclusively NOTES transvaginal cholecystectomy versus laparoscopic routes: an experimental study in swine

Abstract

Background

Methods

Results

Conclusions

Neu im Fachgebiet Chirurgie

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Fehlerkultur in der Medizin – Offenheit zählt!

Mehr Frauen im OP – weniger postoperative Komplikationen

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2012

Stenting versus gastrojejunostomy for management of malignant gastric outlet obstruction: comparison of clinical outcomes and costs

Differences in biomechanical stability using various fibrin glue compositions for mesh fixation in endoscopic inguinal hernia repair

Radiofrequency energy antenna coupling to common laparoscopic instruments: practical implications

The risk of postpolypectomy bleeding during colonoscopy in patients with early liver cirrhosis

Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)

Trends in adolescent bariatric surgery evaluated by UHC database collection

Update Chirurgie