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. 2016:2016:7320275.
doi: 10.1155/2016/7320275. Epub 2016 Jun 14.

Comparison of Inflammatory Response to Transgastric and Transcolonic NOTES

Tomas Hucl  1 , Marek Benes  1 , Matej Kocik  2 , Alla Splichalova  3 , Jana Maluskova  4 , Martin Krak  5 , Vera Lanska  6 , Marie Heczkova  1 , Eva Kieslichova  5 , Martin Oliverius  2 , Julius Spicak  1
Affiliations

Comparison of Inflammatory Response to Transgastric and Transcolonic NOTES

Tomas Hucl et al. Gastroenterol Res Pract. 2016.

Abstract

Aims. The aim of our study was to determine the physiologic impact of NOTES and to compare the transgastric and transcolonic approaches. Methods. Thirty pigs were randomized to transgastric, transcolonic, or laparoscopic peritoneoscopy. Blood was drawn and analyzed for C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin- (IL-) 1β, IL-6, WBCs, and platelets. Results. Endoscopic closure with an OTSC was successful in all 20 animals. The postoperative course was uneventful in all animals. CRP values rose on day 1 in all animals and slowly declined to baseline levels on day 14 with no differences between the groups (P > 0. 05, NS). The levels of TNF-α were significantly increased in the transcolonic group (P < 0 VSports手机版. 01); however this difference was already present prior to the procedure and remained unchanged. No differences were observed in IL1-β and IL-6 values. There was a temporary rise of WBC on day 1 and of platelets on day 7 in all groups (P > 0. 05, NS). Conclusions. Transgastric, transcolonic, and laparoscopic peritoneoscopy resulted in similar changes in systemic inflammatory markers. Our findings do not support the assumption that NOTES is less invasive than laparoscopy. .

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Figures

Figure 1
Figure 1
OTSC closure in stomach and colon at autopsy. (a) Serosal site of stomach closure. (b) Mucosal site of stomach closure. (c) Serosal site of colon closure. (d) Mucosal site of colon closure.
Figure 2
Figure 2
Histopathology of closure site (H&E, 50x). (a) Purulent exudate at site of closure, 10x. (b) Gram-positive staining at closure site, 20x.
Figure 3
Figure 3
Comparison between transgastric, transcolonic, and laparoscopic peritoneoscopy in levels of (a) C-reactive protein; (b) TNF-α; (c) leukocytes; (d) platelets. Values are shown as means and vertical bars representing SEM.
See this image and copyright information in PMC

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