Literature DB >> 18594926

Randomized blinded trial shows relative thrombocytopenia in natural orifice translumenal endoscopic surgery compared with standard laparoscopy in a porcine survival model.

Juliane Bingener1, Joel Michalek, Kent Van Sickle, Wayne Schwesinger.   

Abstract

BACKGROUND: Anecdotal reports of natural orifice translumenal endoscopic surgery (NOTES) procedures in patients are emerging. Whether the new procedure truly is less invasive is not known. Perioperative hematologic parameters during NOTES was compared with those during standard laparoscopy.
METHODS: For this study, 12 swine were randomized to transgastric peritoneoscopy with air or diagnostic laparoscopy using carbon dioxide. Arterial and venous catheters provided cardiopulmonary parameters and blood draws at baseline and up to 7 days postoperatively. The animals survived for 14 days. Data were analyzed by an investigator blinded to the procedure performed. Treatments were contrasted in terms of the mean outcome using a repeated measures linear model.
RESULTS: All experiments were successfully completed. No gastric leak or peritonitis resulted. One NOTES animal died of hemorrhagic gastritis on postoperative day 3 due to bleeding distant from the gastrotomy site. Two animals in the laparoscopy group and one animal in the endoscopy group experienced respiratory compromise requiring disinflation. A widening pulse pressure and lower bladder pressure were observed in the NOTES group compared with the laparoscopy group (p < 0.001). Pre- and postoperative laboratory results showed an increase in the white blood cell count (1,000/ml) from 16.83 +/- 1.94 in the laparoscopy group and 15.17 +/- 0.41 in the NOTES group at baseline to 24.17 +/- 3.25 and 23.33 +/- 3.88, respectively, on postoperative day 7, but no difference between the groups (p = 0.6). The platelet count (1,000/ml) showed a difference between the two groups, changing from 422.5 +/- 97.49 to 446.33 +/- 89.86 in the laparoscopy group and from 368 +/- 105 to 299.5 +/- 161.9 in the NOTES group (p = 0.03).
CONCLUSION: Significant differences in measured but not clinically apparent parameters were encountered. A potentially significant thrombocytopenia clinically was encountered in the NOTES group. The physiologic impact of NOTES procedures beyond the absence of abdominal incisions should be investigated further.

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Year:  2008        PMID: 18594926     DOI: 10.1007/s00464-008-0013-y

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  14 in total

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Authors:  Anthony N Kalloo; Vikesh K Singh; Sanjay B Jagannath; Hideaki Niiyama; Susan L Hill; Cheryl A Vaughn; Carolyn A Magee; Sergey V Kantsevoy
Journal:  Gastrointest Endosc       Date:  2004-07       Impact factor: 9.427

2.  Plasma proteolysis and circulating cells in relation to varying endotoxin concentrations in porcine endotoxemia.

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3.  Gastroenterologists as surgeons: what they need to know.

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Journal:  Gastrointest Endosc       Date:  2005-03       Impact factor: 9.427

4.  Transgastric surgery in the abdomen: the dawn of a new era?

Authors:  Juergen Hochberger; Wolfram Lamadé
Journal:  Gastrointest Endosc       Date:  2005-08       Impact factor: 9.427

5.  ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery. October 2005.

Authors:  D Rattner; A Kalloo
Journal:  Surg Endosc       Date:  2006-02       Impact factor: 4.584

Review 6.  The immunomodulatory effects of laparoscopic surgery.

Authors:  Mark Corrigan; Ronan A Cahill; Henry Paul Redmond
Journal:  Surg Laparosc Endosc Percutan Tech       Date:  2007-08       Impact factor: 1.719

7.  Experimental studies of transgastric gallbladder surgery: cholecystectomy and cholecystogastric anastomosis (videos).

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Journal:  Gastrointest Endosc       Date:  2005-04       Impact factor: 9.427

8.  Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in a porcine model.

Authors:  Sanjay B Jagannath; Sergey V Kantsevoy; Cheryl A Vaughn; Sydney S C Chung; Peter B Cotton; Christopher J Gostout; Robert H Hawes; Pankaj J Pasricha; Diana G Scorpio; Carolyn A Magee; Laurie J Pipitone; Anthony N Kalloo
Journal:  Gastrointest Endosc       Date:  2005-03       Impact factor: 9.427

9.  Early platelet aggregation as a cause of thrombocytopenia in classical swine fever.

Authors:  M J Bautista; E Ruiz-Villamor; F J Salguero; P J Sánchez-Cordón; L Carrasco; J C Gómez-Villamandos
Journal:  Vet Pathol       Date:  2002-01       Impact factor: 2.221

10.  Detrimental effects of N(omega) nitro-L-arginine methyl ester (L-NAME)in experimental Escherichia coli sepsis in the newborn piglet.

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  4 in total

1.  Totally NOTES (T-NOTES) transvaginal cholecystectomy using two endoscopes: preliminary report.

Authors:  Luiz Henrique de Sousa; José Américo Gomides de Sousa; Luiz Henrique de Sousa Filho; Murilo Miranda de Sousa; Vitor Miranda de Sousa; Ana Patricia Miranda de Sousa; Ricardo Zorron
Journal:  Surg Endosc       Date:  2009-04-03       Impact factor: 4.584

2.  Natural orifice transluminal endoscopic surgery vs laparoscopic ovariectomy: complications and inflammatory response.

Authors:  Jan Martínek; Ondřej Ryska; Tereza Filípková; Radek Doležel; Stefan Juhas; Jan Motlík; Monika Holubová; Vladimír Nosek; Barbora Rotnáglová; Miroslav Zavoral; Miroslav Ryska
Journal:  World J Gastroenterol       Date:  2012-07-21       Impact factor: 5.742

3.  Comparison of Inflammatory Response to Transgastric and Transcolonic NOTES.

Authors:  Tomas Hucl; Marek Benes; Matej Kocik; Alla Splichalova; Jana Maluskova; Martin Krak; Vera Lanska; Marie Heczkova; Eva Kieslichova; Martin Oliverius; Julius Spicak
Journal:  Gastroenterol Res Pract       Date:  2016-06-14       Impact factor: 2.260

4.  Acute inflammatory response to transgastric natural orifice transluminal endoscopic surgery peritoneoscopy: an experimental study in swine.

Authors:  Marcelo Rezende; Edna Frasson de Souza Montero; Reinaldo Salomão; Milena Brunialti; Rodrigo Rodrigues; Gustavo Gomes; Alice Della Libera; Angelo Ferrari; Ermelindo Della Libera
Journal:  Clinics (Sao Paulo)       Date:  2013-11       Impact factor: 2.365

  4 in total

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