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1.
Acta Cir Bras ; 30(10): 691-703, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26560428

RESUMO

PURPOSE: To evaluate and compare clinical and inflammatory responses to the surgical trauma caused by cholecystectomy via several access approaches: single-port umbilical incision (SILS), transvaginal natural orifice transluminal endoscopic surgery (NOTES), laparoscopy, and Laparotomy. METHODS: Twenty-eight female pigs were equally divided into four groups and submitted to cholecystectomy by single-port umbilical incision, transvaginal NOTES, laparoscopy, or Laparotomy. An additional five animals served as controls (sham group). Animals were monitored perioperatively regarding anesthesia and surgical procedure times, as well as for the presence of complications. Postoperatively, they were evaluated regarding time to ambulation and feeding, and the presence of clinical events. Procalcitonin, C-reactive protein (CRP), and AQUI feron-gamma (IFN-γ) measurements were performed before surgery and immediately, two days, and seven days after surgery. Animals were sacrificed and necropsied at seven days after surgery. RESULTS: All procedures were successfully performed as proposed in each group. Only minor complications, such as gallbladder perforation and bleeding from the liver bed, were observed during surgery in all groups. The vaginal NOTES group showed higher anesthesia and surgical procedure times compared to the other groups (p<0.001). No other between-group differences in perioperative or postoperative times, clinical evolution, or serum inflammatory markers were observed. Only adhesions were found on necropsy, with no differences between groups. CONCLUSION: The single-port umbilical and transvaginal NOTES access approaches were feasible and safe compared to laparoscopic and laparotomy for cholecystectomy.


Assuntos
Colecistectomia/efeitos adversos , Colecistectomia/métodos , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Cirurgia Endoscópica por Orifício Natural/métodos , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Parede Abdominal/patologia , Parede Abdominal/cirurgia , Animais , Proteína C-Reativa/análise , Calcitonina/sangue , Feminino , Interferon gama/sangue , Complicações Intraoperatórias , Duração da Cirurgia , Complicações Pós-Operatórias , Precursores de Proteínas/sangue , Reprodutibilidade dos Testes , Suínos , Síndrome de Resposta Inflamatória Sistêmica/patologia , Aderências Teciduais/patologia , Umbigo/cirurgia , Vagina/cirurgia
2.
Acta cir. bras ; 30(10): 691-703, tab
Artigo em Inglês | LILACS | ID: lil-764391

RESUMO

PURPOSE: To evaluate and compare clinical and inflammatory responses to the surgical trauma caused by cholecystectomy via several access approaches: single-port umbilical incision (SILS), transvaginal natural orifice transluminal endoscopic surgery (NOTES), laparoscopy, and Laparotomy.METHODS: Twenty-eight female pigs were equally divided into four groups and submitted to cholecystectomy by single-port umbilical incision, transvaginal NOTES, laparoscopy, or Laparotomy. An additional five animals served as controls (sham group). Animals were monitored perioperatively regarding anesthesia and surgical procedure times, as well as for the presence of complications. Postoperatively, they were evaluated regarding time to ambulation and feeding, and the presence of clinical events. Procalcitonin, C-reactive protein (CRP), and AQUI feron-gamma (IFN-γ) measurements were performed before surgery and immediately, two days, and seven days after surgery. Animals were sacrificed and necropsied at seven days after surgery.RESULTS: All procedures were successfully performed as proposed in each group. Only minor complications, such as gallbladder perforation and bleeding from the liver bed, were observed during surgery in all groups. The vaginal NOTES group showed higher anesthesia and surgical procedure times compared to the other groups (p<0.001). No other between-group differences in perioperative or postoperative times, clinical evolution, or serum inflammatory markers were observed. Only adhesions were found on necropsy, with no differences between groups.CONCLUSION: The single-port umbilical and transvaginal NOTES access approaches were feasible and safe compared to laparoscopic and laparotomy for cholecystectomy.


Assuntos
Animais , Feminino , Colecistectomia/efeitos adversos , Colecistectomia/métodos , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Cirurgia Endoscópica por Orifício Natural/métodos , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Parede Abdominal/patologia , Parede Abdominal/cirurgia , Proteína C-Reativa/análise , Calcitonina/sangue , Complicações Intraoperatórias , Interferon gama/sangue , Duração da Cirurgia , Complicações Pós-Operatórias , Precursores de Proteínas/sangue , Reprodutibilidade dos Testes , Suínos , Síndrome de Resposta Inflamatória Sistêmica/patologia , Aderências Teciduais/patologia , Umbigo/cirurgia , Vagina/cirurgia
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