DOES PNEUMOPERITONEUM DURING LAPAROSCOPY INCREASE BACTERIAL TRANSLOCATION

Background: To evaluate the impact of laparoscopy in the presence of p eritonitis, this study was designed to assess bacteremia caused by E. coli-induced peritonitis with a carbon dioxide pneumoperitoneum in a r at model, Methods: Sixty Sprague-Dawley rats were divided into inoculu m groups (no E. coli, 10(6) colony-forming units [CFU] E. coli. and 10 (8) CFU E. coli), followed by induction of a carbon dioxide pneumoperi toneum or no pneumoperitoneum. Fifteen-minute-interval blood cultures were obtained to determine time of bacteremia development. Statistical assessment to determine significant differences among groups was done using ANOVA and t-test analysis. Results: A total of 20 animals with E, coli introduced into the peritoneum and a carbon-dioxide-induced pn eumoperitoneum had more frequent positive blood cultures at all time i ntervals compared to identical inoculum subgroups without a pneumoperi toneum. ANOVA revealed a significant difference in bacteremia within t he same concentration inoculum groups in animals receiving a pneumoper itoneum vs none (p < 0.01). Bacteremia increased significantly as inoc ulum concentrations increased (25% with 10(6) E, coli inoculum vs 80% with 10(8) E. coli), especially among the insufflated subgroups (45% w ith 10(6) E. coli vs 100% with 10(8) E. coli) over 180 min (p < 0.01). Conclusion: Carbon dioxide pneumoperitoneum increases the incidence o f E. coli bacterial translocation from the peritoneum into the bloodst ream in this rat model.