Immunologic parameters during NOTES compared with laparoscopy in a randomized blinded porcine trial

Abstract

Cytokines and WBC did not differ between laparoscopic and NOTES groups during the initial 24 h. These findings do not currently support the assumption that NOTES is less invasive than laparoscopy. The late TNF-alpha elevation contradicts other studies and requires further examination.

Peritoneal inflammatory response of natural orifice translumenal endoscopic surgery (NOTES) versus laparoscopy with carbon dioxide and air pneumoperitoneum

“…This study's major conclusions were that the initial physiologic response was very similar among the groups but that in the late postoperative period, NOTES generated an immunosuppressed response. However, a recent study reexamining this conclusion did not produce similar results [2]. The findings showed a slight continued increase in inflammation over time.…”

Laparoscopic Colopexy in Dogs

“…Acute-phase cytokines (APPs) have been utilized to provide a more objective, quantitative measure of operative trauma [2]. Thus, the purpose of the study reported here was to describe a laparoscopic technique for colopexy in 8 healthy dogs and investigate the systemic inflammatory response to the surgical procedure.…”

Assessing the invasiveness of NOTES perforated viscus repair: a comparative study of NOTES and laparoscopy

“…At baseline, TNF-a levels were equivalent between the experimental groups; however, a significant difference in TNF-a variation from baseline to the conclusion of the procedure, POD 1, and POD 7 was noted between groups, suggesting a possible decreased stress response from the animals that underwent NOTES repair. As other researchers have identified, cytokine analysis in NOTES animal models has had mixed results [3,25]. A weakness in our study is the lack of sensitivity of the cytokine ELISAs in the low range, which led to missing values.…”

“…Using the intraoperatively placed central venous catheter, serum samples for WBC, TNF-a, IL-1, and IL-6 analysis were collected at baseline (prior to the start of the procedure), after the 4-h waiting period, at the conclusion of the procedure, and on postoperative days (POD) 1, 7, and 14 to compare the data with other studies that have reported on inflammatory reaction during NOTES [3,25,26].…”