Does laparoscopy increase bacteremia and endotoxemia in a peritonitis model?

BACKGROUND

Laparoscopy is increasingly used in patients with intraabdominal bacterial infection although pneumoperitoneum may increase bacteremia by elevated intraabdominal pressure.

METHODS

The influence of laparotomy and laparoscopy on bacteremia, endotoxemia, and postoperative abscess formation was investigated in a rat model. Rats received intraperitoneally a standardized fecal inoculum and underwent laparotomy (n = 20), or laparoscopy (n = 20), or no further manipulation in the control group (n = 20).

RESULTS

Bacteremia and endotoxemia were higher after laparotomy and laparoscopy compared to the control group (p = 0.01) 1 h after intervention. One hour after intervention, aerobic and anaerobic bacterial species were detected in the laparotomy group while only anaerobic bacteria were found in the other two groups. Although bacteremia and endotoxemia did not differ among the three groups after 1 week, the mean number of intraperitoneal abscesses was significantly higher (p < 0.05) after laparotomy (n = 10) compared with laparoscopy (n = 6) and control group (n = 5).

CONCLUSION

Laparoscopy does not increase bacteremia and intraperitoneal abscess formation compared to laparotomy in an animal model of peritonitis.