The effect of pneumoperitoneum on bacterial clearance and RES functions ina model of E-coli peritonitis

The use of laparoscopic surgery in peritonitis has increased rapidly. The p resent study examined the effects of pneumoperitoneum on bacterial clearanc e. Spraque-Dawley rats were divided into six groups of seven animals. In gr oups 1 and 4, laparotomy with a midline incision was performed and 10(9) E. coli in a volume of 1 mi inserted into the peritoneal cavity. Groups 2, 3, 5, 6 received an identical quantity of E. coli by intraperitoneal injectio n. Groups 3 and 6 received carbon dioxide pneumoperitoneum at a constant pr essure of 5 mmHg for 60 minutes after intraperitoneal injection of E. coli. In one hour groups; the mean bacterial counts per lung from the E. coli in jection with laparotomy group was significantly higher than for the E, coli injection with pneumoperitoneum group (p < 0.05). The mean bacterial count s per kidney in the E. coli injection with laparotomy group was higher comp ared with the E. coli injection and E. coli injection with pneumoperitoneum groups (p < 0.0001). There was statistically significant difference in qua ntitative bacteraemia between the E. coli injection with laparotomy group a nd the E. coli injection or E. coli injection with pneumoperitoneum groups (p < 0.05). In four-hour groups; the mean bacterial counts of lungs and liv er-spleen were significantly higher in the E. coli injection with laparotom y group than in the E. coli injection and E. coli injection with pneumoperi toneum groups (p < 0.05 and p < 0.001 respectively). The quantitative bacte ria was significantly higher in the E. coli injection with laparotomy group than in the E. coli injection and E. coli injection with pneumoperitoneum groups (p < 0.05). This study demonstrates that pneumoperitoneum impairs th e clearance of bacteria from the peritoneal cavity in an experimental model of peritonitis. However, we could not detect the deleterious effects of pn eumoperitoneum compared with laparotomy.