ArticleSurgical endoscopy2011
Transgastric endoscopic peritoneoscopy does not lead to increased risk of infectious complications.
Article in Surgical endoscopy, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 25 citations in OpenAlex.
- Intra-abdominal bacterial contamination in TAMIS total mesorectal excision for rectal carcinoma: a prospective study.Surgical endoscopy · 2015Trial
- Oral chlorhexidine and microbial contamination during endoscopy: possible implications for transgastric surgery. A randomized, clinical trial.Surgical endoscopy · 2013Trial
- Review of Pure Endoscopic Full-Thickness Resection of the Upper Gastrointestinal Tract.Gut and liver · 2015Review
- Emerging Techniques in Minimally Invasive Surgery. Pros and Cons.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2015Review
- Transanal endoscopic microsurgery for upper rectal tumors.Surgical endoscopy · 2014Article
- Natural orifice translumenal endoscopic surgery applications in clinical practice.World journal of gastrointestinal endoscopy · 2012Article
- Natural orifice translumenal endoscopic surgery in humans: a review.Minimally invasive surgery · 2012Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt remains important to determine the risk of bacterial contamination and infectious complications of the peritoneal cavity as it pertains to transgastric natural orifice translumenal endoscopic surgery (NOTES) procedures. The infectious implications of such procedures have been quantified in animal models. This report discusses the infectious risks of transgastric endoscopic peritoneoscopy (TEP) in a human clinical trial.
methodsUnder institutional review board approval, 40 patients scheduled for laparoscopic Roux-en-Y gastric bypass (LRYGB) participated in this study. The TEP procedure was performed without preoperative gastric decontamination and without laparoscopic guidance. Preoperative intravenous antibiotics were given. Saline aspirates were taken from the gastric lumen before endoscopic gastrotomy creation and from the peritoneal cavity after transgastric access. Samples were sent for culture, identification, and bacterial counts. Subgroup analysis was performed on patients taking proton pump inhibitors (PPIs). These data were compared with data for "sterile" peritoneal aspirates from a historical cohort of 50 patients undergoing LRYGB.
resultsThe median number of bacteria isolated from the gastric aspirates was 980 colony-forming units (CFU)/ml (n=40). The median number of bacteria isolated from the peritoneal aspirates was 323 CFU/ml. Cross-contamination from the stomach to the peritoneal cavity was documented in eight cases. No abscesses or anastomotic leaks were recorded. One port-site infection occurred. Subgroup analysis of 15 patients receiving PPIs showed elevated bacterial counts in gastric aspirates and the post-TEP peritoneal samples compared with patients not receiving PPIs (n=25). This subgroup on PPI's did not have an increase in infectious complications.
conclusionsContamination of the peritoneal cavity does occur with TEP, but this does not lead to an increased risk of infectious complications. Similarly, patients receiving PPIs have an increased gastric bacterial load and increased contamination after TEP but not an increased risk of infectious complications.
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