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2021, Number 1

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Rev Mex Cir Endoscop 2021; 22 (1)

Narrative review of the effects of laparoscopic pneumoperitoneum on experimental models with peritonitis

Garteiz-Martínez D, Weber-Sánchez A

Language: Spanish
References: 39
Page: 14-23
PDF size: 211.12 Kb.


ABSTRACT

The use of laparoscopy in cases of peritonitis has generated great controversy due to the contradictory results found in the literature over the effects that pneumoperitoneum can have on the infectious, immunologic, and hemodynamic states of the subjects. With the objective of evaluating what is currently known about the effects of pneumoperitoneum on peritonitis a narrative review, of the last 25 years, was conducted using 37 animal-model publications. Due to the great diversity in results, it is difficult to obtain absolute conclusions, but we can summarize the most important findings as follows: the use of pneumoperitoneum can be associated with a higher rate of septic complications when peritonitis has been prolonged and when the bacterial inoculum is greater; the combination of peritonitis and pneumoperitoneum cause parietal peritoneum damage but it is not clear whether this may favor bacterial translocation and endotoxemia; higher pneumoperitoneum pressures, in association with peritonitis, may produce additional hemodynamic changes such as reduced splanchnic perfusion and cardiodepression that exacerbate the effects of peritonitis; there is evidence that animals with peritonitis that undergo exposure to pneumoperitoneum have a better inflammatory response and a superior preservation of their immunologic status.


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