Hakan ATAŞ, Kemal KILIÇ, Erdal COŞGUN, İpek MUMCUOĞLU, Sevilay SEZER, SETTAR BOSTANOĞLU, Attila İŞGÖREN, Esra UÇAR YILMAZ ÖZHAMAM, Fatih Mehmet AVŞAR, İbrahim SAKÇAK

The Prevention of the Development of Peritonitis with Diff erent Disinfectants to Compare the Efficacy of Gastric Lavage at the NOTES

Doğal açıklıklar yoluyla endoskopik cerrahi (NOTES) uygulamalarında vücut boşlukları ve kullanılan endoskoptan kaynaklanan enfeksiyon riski vardır. Bu çalışmada transgastrik intraperitoneal cerrahi uygulamalarında peritoneal enfeksiyon riskini azaltmada gastrik lavajın etkinliği ve gerekliliği araştırıldı. Çalışmamızda Wistar-Albino cinsi rat'lar 8'erli 4 gruba ayrıldı. 3 gruba farklı dezenfektanlar ile gastrik lavaj yapıldı, 4. gruba ise lavaj yapılmadı. Postoperatif 1. ve 14. günlerde kan alınarak lökosit sayımı yapıldı, C- reactive protein ölçüldü. Postoperatif 14. gün rat'lar sakrifiye edildi. Peritoneal kaviteden aerob ve anaerob kültür numuneleri, mide duvarı ve perigastrik peritondan biyopsi örnekleri alındı. 14. günde hayvanlar sakrifiye edildiklerinde makrokopik apse formasyonu olan hiçbir hayvan yoktu. Biyopsilerin patolojik incelemesinde lavaj yapılanlarda daha az olmak üzere olarak tüm gruplarda infl amatuar reaksiyon, mikroapse formasyonları ve yabancı cisim dev hücreleri gözlendi. Tüm gruplarda 1. ölçüm değerlerine gore Lökosit ve CRP ölçümlerinde yükselme oldu. Kültür numunelerinin incelemesinde 7 farklı ratta üreme olurken, anaerobik kültürlerde üreme olmadı. Sonuç olarak, transgastrik peritoneoskopide cerrahi uygulamaların daha güvenle yapılmasını sağlamak için gastrik lavaj yapılmalıdır. Bu amaçla kullanılan dezenfektanlar arasında fark yoktur. Serum fizyolojik ile lavaj yapılması yeterlidir.

Makale Kodu (Article Code): KVFD-2010-3080

In the implementation of natural orifice transluminal endoscopic surgery (NOTES) there is a risk of infection arising from the orifices of the body and the endoscope used. This study investigates the need for and efficiency of gastric lavage in reducing the risk of peritoneal infection in transgastric intraperitoneal surgery. In this study, Wistar-Albino rats were divided into 4 groups of 8. Gastric lavage was performed with three, but it was not performed on group 4. Blood samples were taken on the first and 14th days postoperatively, and a leukocyte count was made and C-reactive protein was measured. On the 14th postoperative day, the rats were sacrificed; aerobic and anaerobic culture specimens were taken from the peritoneal cavity, and biopsy samples were taken. Pathological examination of biopsy lavage in those groups, all for less infl ammatory reaction and foreign body giant cell formation mikroabses were observed. In the all groups Leukocyte count and CRP measurements according to measurement values are rising. Culture examination of samples of seven diff erent rats, while producing, anaerobic culture was not isolated in. As a result of gastric lavage should be done to ensure that surgery more safely performed of transgastric peritoneoscopy. There is no diff erence between the disinfectant solutions used, and the use of normal saline for gastric lavage is sufficient.

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