Chang Cheow K, Zdon Michael J
Department of Surgery, Chicago Medical School of Rosalind Franklin University of Medicine and Science at Mount Sinai Hospital Medical Center, Chicago, IL 60608, USA.
Surg Laparosc Endosc Percutan Tech. 2005 Jun;15(3):124-8. doi: 10.1097/01.sle.0000166971.46595.0c.
It is generally accepted that greater inflammatory response is observed after laparotomy than laparoscopy in animal models. However, in a previous study, we reported there are no significant differences in the systemic response of tumor necrosis factor (TNF)-alpha between the laparotomy and laparoscopy groups in a rat model of endotoxic shock. The present study extends this investigation to the inflammatory response of 2 additional proinflammatory mediators, interleukin (IL)-1beta and IL-6, in septic rats after laparotomy and laparoscopy in the same animal model. Rats received lipopolysaccharide (LPS) intraperitoneally and underwent laparotomy (n = 5), laparoscopy (n = 5), or no surgical intervention (n = 5). A control group received anesthesia only (n = 5). Serum IL-1beta and IL-6 levels were significantly higher at 2, 4, and 8 hours after LPS injection and were equally suppressed in the laparotomy and laparoscopic groups (P < 0.05). Liver IL-1beta mRNA and protein levels were significantly inhibited at 2, 4, and 8 hours in the laparotomy and laparoscopic groups. Liver IL-6 mRNA (2 and 4 hours) and protein (4 hours) levels were also suppressed significantly in both the laparotomy and laparoscopic groups (P < 0.05). There were no significant differences in hepatic levels of mRNA and protein of IL-beta and IL-6 in both the laparotomy and laparoscopic groups. These results extend our previous finding demonstrating the suppression of TNF-alpha in both the laparotomy and laparoscopic groups. The behavior of the markers used in our study demonstrated that the inflammatory response does not differ between laparotomy and laparoscopic surgery in our rat model of endotoxic shock.
在动物模型中,一般认为开腹手术后的炎症反应比腹腔镜手术后更强烈。然而,在之前的一项研究中,我们报告在内毒素休克大鼠模型中,开腹手术组和腹腔镜手术组在肿瘤坏死因子(TNF)-α的全身反应方面没有显著差异。本研究将这一调查扩展到在同一动物模型中,对开腹手术和腹腔镜手术后脓毒症大鼠体内另外两种促炎介质白细胞介素(IL)-1β和IL-6的炎症反应进行研究。大鼠腹腔内注射脂多糖(LPS),并接受开腹手术(n = 5)、腹腔镜手术(n = 5)或不进行手术干预(n = 5)。对照组仅接受麻醉(n = 5)。LPS注射后2、4和8小时,血清IL-1β和IL-6水平显著升高,且在开腹手术组和腹腔镜手术组中均受到同等程度的抑制(P < 0.05)。开腹手术组和腹腔镜手术组在LPS注射后2、4和8小时,肝脏IL-1β mRNA和蛋白水平均受到显著抑制。开腹手术组和腹腔镜手术组肝脏IL-6 mRNA(2和4小时)和蛋白(4小时)水平也均受到显著抑制(P < 0.05)。开腹手术组和腹腔镜手术组肝脏IL-β和IL-6的mRNA和蛋白水平均无显著差异。这些结果扩展了我们之前的发现,即开腹手术组和腹腔镜手术组中TNF-α均受到抑制。我们研究中使用的标志物表现表明,在内毒素休克大鼠模型中,开腹手术和腹腔镜手术的炎症反应没有差异。