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Natural orifice transluminal endoscopic surgeryvs laparoscopic ovariectomy:Complications and inflammatory response

World Journal of Gastroenterology 2012年第27期18卷 3558-3564页

作者： Jan Martínek Ondej Ryska Tereza Filípková Radek Dolezel stefan juhas Jan Motlík Monika Holubová Vladimír Nosek Barbora Rotnáglová Miroslav Zavoral Miroslav Ryska Department of Internal Medicine 1st Faculty of MedicineUniversity Military Hospital16000 PragueCharles UniversityCzech Republic Department of Surgery 2nd Faculty of MedicineUniversity Military HospitalCharles University16000 PragueCzech Republic Department of Surgery Domazlice Hospital34401 DomazliceCzech Republic Institute of Animal Physiology and Genetics Academy of Sciences27721 LibechovCzech Republic Department of Gastroenterology Jablonec Hospital46601 Jablonec nad NisouCzech Republic

AIM:To compare natural orifice transluminal endoscopic surgery (NOTES) vs standard laparoscopic ovariectomy in mini pigs with respect to technical aspects,complications and parameters of systemic inflammatory ***:This was a randomized,experimental,survival *** female mini pigs underwent NOTES transgastric ovariectomy (NOTES group) and ten female mini pigs underwent laparoscopic ovariectomy (LAP group).A "percutaneous endoscopic gastrostomy" approach with guidewire and sphincterotome was used for gastrotomy *** ovary was resected using standard biopsy forceps and a *** access site was closed using a "KING" closure with a single endoloop and several *** the laparoscopic group,a three-port laparoscopy and an ovariectomy were performed with the use of standard laparoscopic devices.C-reactive protein (CRP),white blood count and interleukin (IL)-6 plasma levels were used as indicators of systemic inflammatory *** animals were euthanized 28 d after ***:All animals survived without *** mean procedure time was 41.3 min ± 17.6 min (NOTES group) and 25.7 min ± 5.25 min (LAP group,P < 0.02).Postmortem examinations demonstrated that 50% and 70% of animals were free of any complications in the NOTES and LAP groups,*** remaining animals developed minor complications (adhesions) in a comparable frequency between the two *** the NOTES group,one animal developed a small intramural gastric abscess close to the gastrotomy site.A minor serous exudate that was present in 50% and 40% of the animals in the NOTES and laparoscopy groups,respectively,was not considered a *** both groups CRP levels increased significantly on the 2nd and 7th postoperative days (POD) and returned to normal after 28 *** POD 2,an increase of CRP level was significantly higher in the NOTES group compared to the LAP *** of IL-6 did not differ from baseline values in either of the groups postoperatively.

关键词： Natural orifice transluminal endoscopic sur-gery Laparoscopy Ovariectomy Systemic inflammatoryresponse

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