The Effect And Compare Of Ear Rabbit's Gastrointestinal Motility In CO₂ Pneumoperitoneum, Non-pneumoperitoneum Technic And Open Surgery

BackgroundThe development of laparoscopic has been more than 100 years, and minimally invasive surgery has become a thermal nouns in modern surgical field. There are three stages in the process of its development:the first stage, the diagnosis laparoscopic era (1901-1933), laparoscopic were used in the diagnosis process of the human disease, and continuously improve the cavity mirrors requirements, improve skills. The second stage, the operation laparoscopic era (1933-1987), the focus of laparoscopic surgery were on the development of laparoscopic surgery and create usable instrument. As the technology improved and the equipment upgraded, laparoscopic surgery slowly revealed the value it should had. The third stage is the modern laparoscopic era (1987-now). With the experiences of first and two stages, laparoscopic surgery had gradually realized systematic and standardization.With the helped of imaging instrument, laparoscopic surgery can operation under direct observation. This provided good conditions for the rapid development of laparoscopic surgery. Nearly 20 years, the development and popularization of laparoscopic surgery have lifted a major transformation of the surgical method, and have pushed a significant progress of surgery. The obvious advantages of laparoscopic surgery, such as small trauma, clear operation field, quick postoperative recovery, less complications and little scar, favored by the doctors and patients. Completely laparoscopic techniques be split into pneumoperitoneum laparoscopic and non-pneumoperitoneum laparoscopic. Pneumoperitoneum laparoscopic surgery needs to build artificial pneumoperitoneum by filling CO2 in abdominal cavity, manufacturing operation space to complete laparoscopic surgery operation. Non-pneumoperitoneum laparoscopic technology is brought anterior abdominal wall by external force, mainly through steel or abdominal wall tiras device realized, manufacturing operation space, complete laparoscopic surgery operation. The substantial difference between two is whether to use CO2 pneumoperitoneum manufacturing operation space. Most basic research has confirmed that the CO2pneumoperitoneum has unfavorable influences to human multiple physiological systems. Related literature mainly concentrated on the study of respiratory system, hemodynamics systemic, tumor growth and transfer and immune status, but less on gastrointestinal dynamics influence. Some scholars have confirmed that CO2 pneumoperitoneum can restrain the gastrointestinal peristalsis. In the situation of CO2 pneumoperitoneum, intra-abdominal pressure heightens, gastrointestinal blood perfusion pressure drops, and reflux vascular resistance increases, gastrointestinal blood flows decrease, at the same time, the height soluble of CO2 leading to hypercapnia and acidosis, and then reduce the sensitivity of gastrointestinal smooth muscle receptors to outside stimuli. Furthermore, CO2 pneumoperitoneum leads to dysfunction of autonomic nervous system, the secretion and regulation of motilin disorder. All of these factors lead to the function of gastrointestinal peristalsis were restrained eventually. But the studies of gastrointestinal peristalsis on non-pneumoperitoneum laparoscopic less. The research information of comparative study on gastrointestinal peristalsis is shortage under the conditions of CO2 pneumoperitoneum, non-pneumoperitoneum laparoscopic and open surgery. Strengthen the research in this respect has certain significance to the development of laparoscopic techniques and clinical application.ObjectiveObserve and compare the effect that CO2 pneumoperitoneum, non-pneumo -peritoneum technic and open surgery to Ear Rabbit gastrointestinal motilityMethodsDivided 30 Ear Rabbit into three groups randomly,Ⅰgroup (CO2 pneumoperitoneum group),Ⅱgroup (non-pneumoperitoneum group),Ⅲgroup (open surgery group),each group of 10. The methods of anesthetic was ear rim intravenous anesthesia by 1% of pentobarbital sodium 3ml/kg. NarcotizedⅠandⅡgroups rabbit respectively, and then did epigastric midline incision by surgery, seam pierced homemade catheter traction in the distal (pylorus 1cm up) and the duodenum (pylorus 1cm under) seromuscularlayer, educed and fixed the catheter traction from abdominal where the recent distance to seam pierced parts, sutured and wrapped. After theⅠandⅡgroups rabbit have recovered, narcotized three groups rabbit respectively,made CO2 pneumoperitoneum, non-pneumoperitoneum and open surgery models. Connected the drawn wire abdominal wall outside ofⅠandⅡgroups directly to transducer wires of the two way physiological recorder.Ⅲgroup were operated by open surgery, and connected the transducer wires of the two way physiological recorder to the homemade catheter traction that have seamed and penetrated asⅠandⅡgroups. Then recorded gastrointestinal peristalsis frequency of rabbit all the three groups in the first hour, the second hour and the third hour respectively. The results were analysed by SPSS 16.0 software, data were showed (x±s). The comparison between groups by repeated measurements variance analysis method, and pairwise comparison by LSD. Inspection standard is a=0.05.ResultTwo way physiological recorder recorded gastrointestinal peristalsis wave successfully. CO2 pneumoperitoneum group,the peristalsis wave numbers of stomach and duodenum gradually decreased in the first hour, the second hour and the third hour,the differences between-group have statistical significance,(P<0.05). In the first hour, the peristalsis wave numbers of stomach and duodenum have not obvious difference between the three groups, (p>0.05). In the second hour, the numbers of CO2 pneumoperitoneum group and open surgery group were significantly less than non-pneumoperitoneum group, the differences have statistical significance,(P<0.05), the numbers of CO2 pneumoperitoneum group and open surgery group have not obvious difference, (p> 0.05). In the third hour, the numbers of CO2 pneumoperitoneum group and open surgery group were largely less than non-pneumoperitoneum group, the differences have statistical significance,(p<0.05), the numbers of CO2 pneumoperitoneum group and open surgery group have not obvious difference, (p>0.05).conclusionCO2 pneumoperitoneum can restrain the gastrointestinal peristalsis, the longer it lasts, the inhibiting effect more obvious. The influence of gastroenteric motility that non-pneumoperitoneum technology produces is smaller than CO2 pneumoperitoneum and open surgery produce. The influence of gastroenteric motility during operation that CO2 pneumoperitoneum produces and open surgery produces have not statistically significant differences.