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The effect of carbon dioxide pneumoperitoneum on the severity of peritonitis.

BACKGROUND
There are still some doubts regarding the reliability of laparoscopic interventions in the presence of generalized peritonitis. The aim of the present experimental study was to investigate the effects of carbon dioxide (CO2) pneumoperitoneum on inflammatory response and peritonitis severity score in experimental peritonitis.


METHODS
21 Wistar albino rats were used in the study. The rats were distributed into three groups: the control group (Group 1, n = 7), the bacterial peritonitis-induced group (Group 2, n = 7), and the peritonitis+CO2 pneumoperitoneum-induced group (Group 3, n = 7). In Groups 2 and 3, peritonitis was induced by intraperitoneally injected Escherichia coli. In Group 3, pneumoperitoneum was induced by giving CO2 insufflations. The rats were sacrificed 24 hours later. Five cc of blood was sampled, and peritoneum tissue was excised from the abdominal region of the rats. Peritonitis severity score, C-reactive protein level and white blood cell count were assessed in all groups.


RESULTS
Peritonitis severity score, C-reactive protein level and white blood cell count were significantly higher in Groups 2 and 3 than Group 1 (both, p < 0.05), while significantly lower in Group 3 than Group 2 (p < 0.05).


CONCLUSION
The results of this study show that CO2 pneumoperitoneum decreases peritonitis severity and systemic inflammatory response in experiments with E. coli-peritonitis and sepsis.