Pneumoperitoneum induced ischemia-reperfusion injury of the peritoneum – Preconditioning may reduce the negative side-effects caused by carbon-dioxide pneumoperitoneum – Pilot study
Affiliations: [a]
Department of Surgical Research and Techniques, University of Pécs, Hungary
| [b] Surgery Clinic, University of Pécs, Hungary
| [c]
Institute of Bioanalysis, University of Pécs, Hungary
Correspondence:
[*]
Corresponding author: Tünde Gyöngyvér Veres, Department of Surgical Research and Techniques, Faculty of Medicine, University of Pécs, H-7624 Pécs, Szigeti str 12., Hungary. Tel.: +36 30 5393565; E-mail: gyongyver.tunde@gmail.com.
Abstract: INTRODUCTION:Laparoscopy is more beneficial than the conventional open technique, however the pneumoperitoneum created may have an ischemic side effect. OBJECTIVE:Our aim was to evaluate the protective effects of preconditioning during laparoscopic cholecystectomies (LC). METHODS:30 patients were randomized into 2 groups: I. PreC (preconditioning: 5 min. inflation, 5 min. deflation, followed by conventional LC), II: LC (conventional LC). Blood samples were taken before hospitalization (C = control), before surgery, after anaesthesia (B.S.), after surgery (A.S.) and 24 hours after the procedure (24 h). Measured parameters were: malondialdehyde (MDA), reduced glutathione (GSH), sulfhydril groups (-SH), superoxide-dismutase (SOD), catalase (CAT), myeloperoxidase (MPO), length of hospitalization and pain (VAS = visual analogue scale). RESULTS:Compared to the BS levels, no significant changes were detected in SOD’s activity and MDA levels. GSH concentrations were significantly increased in the PreC group after operation. SH-, MPO, CAT and liver function enzymes were not significantly different. Hospitalization was shorter in the PreC group. Based on the VAS score patients had less pain in the PreC group. CONCLUSION:Significant differences concerning PreC group were found in GSH values. In the PreC group pain decreased by 2-2.5 units following the procedure, 24 h after surgery, and hospitalisation was also significantly shorter. In our pilot study the potential protective effect of preconditioning could be defined.
