DOES LAPAROSCOPY INCREASE BACTEREMIA AND ENDOTOXEMIA IN A PERITONITISMODEL

Background: Laparoscopy is increasingly used in patients with intraabd ominal bacterial infection although pneumoperitoneum may increase bact eremia by elevated intraabdominal pressure. Methods: The influence of laparotomy and laparoscopy on bacteremia, endotoxemia, and postoperati ve abscess formation was investigated in a rat model, Rats received in traperitoneally 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 highe r 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 whi le only anaerobic bacteria were found in the other two groups. Althoug h bacteremia and endotoxemia did not differ among the three groups aft er 1 week, the mean number of intraperitoneal abscesses was significan tly higher (p < 0.05) after laparotomy(n = 10) compared with laparosco py (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.