Evaluation of the Effects of Laparotomy and Laparoscopy on the Immune System in Intra-Abdominal Sepsis-A Review
Evaluation of the Effects of Laparotomy and Laparoscopy on the Immune System in Intra-Abdominal Sepsis-A Review
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DOI：
10.1080/08941930802438914
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发表时间：
2008-11-01
影响因子：
1.9
通讯作者：
Kostakis, Alkiviadis
中科院分区：
文献类型：
--
作者：
Karantonis, Fotios-Filippos;Nikiteas, Nikolaos;Kostakis, Alkiviadis
该综述描述了最常见的腹内脓毒症的实验模型。此外，它还概述了在腹内脓毒症的实验模型中比较开腹和腹腔镜术在免疫反应方面区别这两种技术的事实。它分别描述了气腹和由腹腔镜或开腹手术造成的创伤对细菌移位和免疫的影响。此外，我们报告了在临床环境中所做的一些努力，其中外科医生试图利用腹腔镜作为治疗模块来治疗腹膜炎或腹腔炎。当然，有必要进行更多的研究，以加强气腹在腹源性败血症中的作用。微创手术似乎不可避免地会被外科医生接受，因为有证据表明，通过造成更少的创伤，愈合反应预计会更有效，特别是在败血症患者中。
This review portrays the most common experimental models of intra-abdominal sepsis. Additionally, it outlines the facts that distinguish laparotomy from laparoscopy, in respect to the immune response, when comparing these two techniques in experimental models of intra-abdominal sepsis. It describes the consequences of pneumoperitoneum and trauma produced by laparoscopy or laparotomy, respectively, on bacterial translocation and immunity. Furthermore, we report the few efforts that have been made in clinical settings, where surgeons have attempted to utilize laparoscopy as a therapeutic module when treating peritonitis or sepsis of abdominal origin. Certainly there is a need for more research in order to fortify the role of pneumoperitoneum in sepsis of abdominal origin. It seems that minimally invasive surgery will inevitably gain acceptance by surgeons, as evidence points that by inflicting less trauma the healing response is expected to be more efficient, especially in septic patients.