Effect Of Abdominal Insufflation On Bacterial Growth In An Experimental Model Of Peritonitis - A Randomized Controlled Trial.

Background: Despite the advantages of laparoscopy, studies suggest that gases used for insufflation may adversely affect patients with peritonitis by bacterial proliferation and impair the clearance of bacteria from the peritoneal cavity.Methods: This was an experimental study conducted on 33 albino-rats from February 2004 to September 2004 in Department of Surgery N.S.C.B, Government Medical College, Jabalpur (MP), India. This study was done to assess the effect of pneumoperitoneum on peritonitis. The rats were divided in three groups (A, B, and C). In group A (control group) 0.5ml of normal saline (5%) was instilled intraperitoneally. In group B and C, a single infusion of 0.5ml suspension containing 1×10 Escherichia coli/ml was instilled intraperitoneally. In group A and C, an additional 5ml of atmospheric air was instilled. The colony counts in each group were noted after 72 hours after laparotomy. Results: In the control group there was no peritoneal contamination, no bacterial growth, none of the rats had died and there was no evidence of pus or pus pockets seen. In the experimental group the mean colony count was 659.91 (±680.34). There were no macroscopic pus pockets or adhesions seen but there was frank pus in one of the rats of this group. The t-value for comparison of colony count was tA/B =3.22 (p<.05). In group C there were no macroscopic pus pockets seen, no adhesions observed and a mean colony count of 840.09 (±681.21) was observed.Conclusion: There is an increase in average colony count in the pneumoperitoneum group as compared to nonpneumoperitoneum group.