A canine model to assess the biochemical stress response to laparoscopic and open surgery.
نویسندگان
چکیده
PURPOSE To develop an animal model to assess the stress response to open and laparoscopic surgery. Such a model would allow objective physiologic assessment of the putative benefits of laparoscopy and provide a framework in which to compare modifications in operative and anesthetic technique that might decrease the stress of surgery. MATERIALS AND METHODS Mongrel dogs underwent laparoscopic (N = 12) or open surgical (N = 12) left nephrectomy. In 11 control animals, after induction of anesthesia and line placement, the animal underwent either no intervention (open surgery sham; N = 6) or pneumoperitoneum only (laparoscopic sham; N = 5). Serum glucose and cortisol were measured preoperatively, at skin closure, and at 4, 8, and 24 hours postoperatively. Values at each time point were compared in the laparoscopic and open surgical nephrectomy groups and in each of the two nephrectomy groups and their respective shams. RESULTS Compared with baseline, there was a sharp rise in serum cortisol at the time of skin closure, with a gradual decline to baseline values by 24 hours, in all experimental animals. Significantly lower serum cortisol concentrations were seen at 4 and 8 hours postoperatively in the laparoscopic group than in the open surgery group. Cortisol was significantly higher in the open group than in the sham-open group at all time points, whereas cortisol was greater in the laparoscopic group than in the pneumoperitoneum-only group only at the 4-hour time point. No differences were seen in serum glucose between groups. CONCLUSIONS The serum cortisol concentration appears to be a good measure of surgical stress in the canine model. The rapid decline in serum cortisol after laparoscopy compared with open surgery may indicate a lesser degree, or quicker resolution, of surgical stress in the former. Furthermore, the similarity in cortisol curves between laparoscopy and pneumoperitoneum only suggests that surgical stress in laparoscopic surgery may be attributable mainly to the effects of pneumoperitoneum.
منابع مشابه
A Prospective Study of Altered Inflammatory Response and Its Clinical Outcome Following Laparoscopic and Open Cholecystectomy
Background: Inflammatory response following surgical trauma has long been a matter of study. Results, however, have been varied. We sought to assess changes in the levels of proinflammatory and anti-inflammatory cytokines in patients undergoing laparoscopic and open cholecystectomy and their impact on the clinical outcome of patients concerning the postoperative pain score.Methods: The study in...
متن کاملLaparoscopic Colon Surgery for Benign Disease: A Comparison to Open Surgery
Backgrounds and Objectives: Today we are witnessed a growing number of minimally invasive surgical techniques for different diseases. Laparoscopic colon surgery as a minimally invasive surgery is currently growing in treatment of malignancies after proving his place in the treatment of benign diseases. We compare in this study results of laparoscopic colorectal surgery with open surgery. Method...
متن کاملکاربرد لاپاراسکوپی در جراحی های حفره بطنی
Laparoscopic technique in recent years has tremendously being used as a non invasive surgery to perform different operation in abdominal and thoracic cavities. This technique has been used from 1987 in different aspect of human surgery. In addition to diagnosis, biopsy, visualizing adhesion and neoplastic structure, recently cholecystectomy and ovariohysterectomy were also commonly being used a...
متن کاملAn investigational study about the conversion risk factors of laparoscopic cholecystectomy to open surgery
Background: Knowing the conversion risk factors of laparoscopic cholecystectomy to open surgery, helps the surgeon to plan for surgery accordingly. This study aimed to determine the risk factors for converting laparoscopic cholecystectomy to open surgery. Methods: In this analytical study, the case information of 1104 patients who underwent laparoscopic cholecystectomy in Shahid Beheshti Hospi...
متن کاملبررسی تأثیر فشارهای کم و زیاد گاز CO2 حین لاپاراسکوپیک کوله سیستکتومی روی آنزیم های کبدی و مقایسه آن با روش باز
Background and purpose: Gallstone is one of the most common problems of hepatobiliary system. Laparoscopic cholecystectomy is a gold standard treatment for this problem. Carbon dioxide (CO2) insufflated in the abdomen for better exposure in laparoscopic cholecystectomy could increase the liver enzyme levels. The goal of this study was to assess the effect of different CO2 pressure (12-16 mm Hg)...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of endourology
دوره 15 10 شماره
صفحات -
تاریخ انتشار 2001