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Demiri CD, Kaselas C, Iliadis S, Tsopozidi M, Spyridakis I. Studying the surgical stress in open and laparoscopic treatment of inguinal hernia in children. Pediatr Investig 2023. [DOI: 10.1002/ped4.12372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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Xiang Y, Xi L. Application of Quantitative Assessment Strategy-Based Nursing Combined with Empathic Nursing in Patients Undergoing Tension-Free Inguinal Herniorrhaphy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:7897027. [PMID: 36212961 PMCID: PMC9536892 DOI: 10.1155/2022/7897027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/20/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022]
Abstract
Objective This study aimed to explore the application of quantitative assessment strategy-based nursing combined with empathic nursing in patients undergoing tension-free inguinal herniorrhaphy. Methods 82 patients who underwent tension-free inguinal herniorrhaphy in our hospital from May 2020 to December 2021 were enrolled. According to the random number table method, they were divided into three groups (A, B, and C). Patients in group A received quantitative assessment strategy-based nursing combined with empathic nursing, and group B received quantitative assessment strategy-based nursing. Group C received a routine intervention. The early recovery of the three groups was observed. Heart rate (HR), oxygen saturation (SpO2), and blood pressure (BP) were recorded before entering the operating room and at the beginning of anesthesia. Mental Health Continuum-Short Form (MHC-SF, adult version) was used to assess the psychological status. The Modified Barthel Index (MBI) score of three groups at different time points was recorded. The complications of the three groups were observed. Results Compared with group C, wound healing time, ambulation time, hospital stay time, and time to resume daily activities in groups A and B were significantly shorter (all P < 0.05). At the beginning of anesthesia, HR and BP levels in the three groups were all decreased, with HR and BP levels in group A lower than those in group C and HR levels in group B lower than those in group C (all P < 0.05). After the intervention, the scores of emotional well-being, psychological well-being, and social well-being in groups A and B were higher than those in group C and the scores of psychological well-being and social well-being in group A were higher than those in group B (all P < 0.05). The daily living ability score of group A was higher than that of groups B and group C at discharge, one month after discharge, and three months after discharge, and the daily living ability score of group B was higher than that of group C at these three time points (all P < 0.05). No significant differences were observed in the incidence of complication rate among the three groups (10.71%, 14.81%, and 29.63%) (χ 2 = 3.616, all P > 0.05). Conclusion Quantitative evaluation strategy-based nursing combined with empathic nursing can effectively improve the early recovery of patients undergoing tension-free inguinal herniorrhaphy, reduce their stress response, and improve their mental health and daily living ability.
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Affiliation(s)
- Yamei Xiang
- Operation Room, Xi'an No. 1 Hospital (The First Affiliated Hospital of Northwest University), Xi'an 710002, Shaanxi, China
| | - Lingyun Xi
- Operation Room, Xi'an No. 1 Hospital (The First Affiliated Hospital of Northwest University), Xi'an 710002, Shaanxi, China
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Akkurt G, Akkurt B, Alptekın E, Birben B, Keşkek M, Erel Ö. Efficacy of Thiol Disulfide Homeostasis and Ischemia Modified Albumin Values in Estimating the Degree of Difficulty for Laparoscopic Cholecystectomy. Comb Chem High Throughput Screen 2021; 24:433-440. [DOI: 10.2174/1386207323666200709165910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/04/2020] [Accepted: 05/16/2020] [Indexed: 11/22/2022]
Abstract
Aim:
The aim of this study was to investigate the efficacy of thiol disulfide homeostasis
and Ischemia Modified Albumin (IMA) values in predicting the technical difficulties that might be
encountered during laparoscopic cholecystectomy.
Materials and Methods:
The study included 65 patients who underwent laparoscopic
cholecystectomy due to cholelithiasis at the General Surgery Clinic of Ankara Numune Training
and Research Hospital. All patients’ demographic data, previous history of cholecystitis, a history
of chronic illness, preoperative white blood count (WBC), liver function tests (AST, ALT),
amylase and lipase levels, intra-operative adhesion score, the ultrasonographic appearance of gall
bladder, duration of hospital stay, duration of operation, thiol disulfide and IMA values were
evaluated.
Results:
Native thiol and total thiol averages were higher in patients without a history of
cholecystitis, and on the other hand, disulfide, disulfide/native thiol rate, disulfide/total thiol rate,
native thiol/total thiol rate and IMA averages were higher in patients with a history of cholecystitis.
While there was a statistically significant negative correlation between native and total thiol values
and age, duration of surgery and duration of hospital stay; IMA, disulfide, disulfide/Total thiol,
Native/Total thiol and disulfide/Native thiol rates were higher in older patients with a longer
duration of surgery and hospital stay. In addition, preoperative IMA, disulfide, disulfide/Total
thiol, Native/Total thiol and disulfide/Native thiol were observed to increase as the degree of
intraoperative pericholecystic adhesion increased.
Conclusion:
We believe that the evaluation of thiol disulfide homeostasis and IMA parameters
prior to laparoscopic cholecystectomy can be used as an effective method for predicting
intraoperative difficulties.
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Affiliation(s)
- Gökhan Akkurt
- Ankara City Hospital, General Surgery Universiteler, 1604. Cd. No: 9 D: No: 9, 06800, Ankara, Turkey
| | - Burcu Akkurt
- Mengen State Hospital, Family Medicine Department, Bolu, Turkey
| | - Emel Alptekın
- Ladik State Hospital, Family Medicine Department, Samsun, Turkey
| | - Birkan Birben
- Ankara City Hospital, General Surgery Department, Ankara, Turkey
| | - Mehmet Keşkek
- Ankara City Hospital, General Surgery Department, Ankara, Turkey
| | - Özcan Erel
- Yildirim Beyazit University Faculty of Medicine, Biochemistry Department, Ankara, Turkey
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DÖĞER C, DUMANLI ÖZCAN AT, ERKILIÇ E, ELLİK S, AKSOY ŞM, ALIŞIK M, EREL Ö. Oxidative Stress in Controlled Hypotension: Assessment with A Novel Oxidative Stress Marker. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.798527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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A comparison of the oxidative stress response in single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair. Wideochir Inne Tech Maloinwazyjne 2020; 15:567-573. [PMID: 33294071 PMCID: PMC7687664 DOI: 10.5114/wiitm.2020.93202] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/13/2020] [Indexed: 01/07/2023] Open
Abstract
Introduction Surgical treatment is always associated with tissue damage and the subsequent development of oxidative stress. Aim To compare the oxidative stress response in patients treated operatively for inguinal hernia with multi-trocar laparoscopic totally extraperitoneal technique (TEP) or single-incision laparoscopic totally extraperitoneal technique (TEP-SI). Material and methods A randomized group of 34 patients with one-sided inguinal hernia was enrolled in the study. Seventeen patients were treated with a standard TEP method (group 1) and the other 17 patients were treated with the TEP-SI technique (group 2). Thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAS) as the oxidative stress markers were measured before surgery (0), 1 day (1) and 4 days (2) after surgery. Results A decrease in TAS on the first day after surgery was observed in both groups. Sustained reduction on the fourth day after surgery was observed in group 1, whereas in group 2 an increase followed. A statistically significant difference was observed in TAS (2 : 0) ratio with a meaningful decrease in group 1. TBARS concentration was elevated 1 day after surgery in both groups. It remained at an elevated level on the fourth day after surgery in group 1, while it decreased in group 2. The duration of surgery was higher in group 2 (mean: 57.5 min) than in group 1 (mean: 50.0 min) (p = 0.0286). Conclusions Oxidative stress levels are lower in patients treated operatively by TEP-SI technique than by TEP. TEP-SI may be considered as a less invasive technique associated with less tissue injury.
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Bains L, Saini R, Hadke N, Koner B, Singh R, Lal P. Evaluation of oxidative stress response in endoscopic and Lichtenstein hernia repair: A randomized control study. INTERNATIONAL JOURNAL OF ABDOMINAL WALL AND HERNIA SURGERY 2020. [DOI: 10.4103/ijawhs.ijawhs_33_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ozcan ATD, Doger C, Ozturk L, Yungul A, Kurtsahin M, Neselioglu S, Ergin M, But A. Comparison of the Effects of Sevoflurane and Desflurane on Thiol-Disulfide Homeostasis in Patients Undergoing Laparoscopic Cholecystectomy. Eurasian J Med 2019; 51:70-74. [PMID: 30911261 DOI: 10.5152/eurasianjmed.2019.18299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective This study aims to compare the effects of different inhalation anesthetics on oxidative status by measuring thiol-disulfide homeostasis in laparoscopic cholecystectomy surgeries. The effect of inhaler agents on thiol-disulfide homeostasis that shows the oxidative status in laparoscopic cholecystectomy is unknown. Materials and Methods In this study, 71 patients planned to undergo laparoscopic cholecystectomy under general anesthesia were included. They were divided into two groups: desflurane (group D, n: 35) and sevoflurane (group S, n: 36). Blood samples were taken before induction (T1), at 30th minute of insufflation (T2) (30th min of ischemia), and at 30th min postdeflation (T3) (30th min of reperfusion). The native thiols (-SH) and total thiols (-SH+ -SS) were determined. The amounts of disulfide (-SS), disulfide/native thiol percent ratios (-SS/-SH), disulfide/total thiol percent ratios (-SS/-SH+-SS), and native thiol/total thiol percent ratios (-SH/-SH+ -SS) were calculated. Results In the sevoflurane group, preoperative values and intraoperative 30th-minute SS-SH ratio were significantly reduced (p=0.017). In the desflurane group, intraoperative native thiol values and postdeflation levels significantly decreased compared to those in the preoperative values (p<0.001). Conclusion We think that the usage of sevoflurane was more protective in terms of the oxidative damage occurring during laparoscopic surgery.
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Affiliation(s)
- Ayca Tuba Dumanlı Ozcan
- Department of Anesthesiology and Reanimation, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Cihan Doger
- Department of Anesthesiology and Reanimation, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Levent Ozturk
- Department of Anesthesiology and Reanimation, Yildirim Beyazit University School of Medicine, Ankara, Turkey
| | - Aysun Yungul
- Department of Anesthesiology and Reanimation, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Muge Kurtsahin
- Department of Anesthesiology and Reanimation, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Salim Neselioglu
- Department of Biochemistry, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Merve Ergin
- Department of Biochemistry, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Abdulkadir But
- Department of Anesthesiology and Reanimation, Yildirim Beyazit University School of Medicine, Ankara, Turkey
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Polat M, Ozcan O, Sahan L, Üstündag-Budak Y, Alisik M, Yilmaz N, Erel Ö. Changes in Thiol-Disulfide Homeostasis of the Body to Surgical Trauma in Laparoscopic Cholecystectomy Patients. J Laparoendosc Adv Surg Tech A 2016; 26:992-996. [DOI: 10.1089/lap.2016.0381] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Murat Polat
- Department of General Surgery, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - Onder Ozcan
- Department of General Surgery, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - Leyla Sahan
- Department of Anesthesiology, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - Yasemin Üstündag-Budak
- Department of Clinical Chemistry, Bursa Yuksek Ihtisas Research and Education Hospital, Bursa, Turkey
| | - Murat Alisik
- Department of Medical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Nigar Yilmaz
- Department of Clinical Chemistry, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - Özcan Erel
- Department of Medical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
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Oxidative stress response after laparoscopic versus conventional sigmoid resection: a randomized, double-blind clinical trial. Surg Laparosc Endosc Percutan Tech 2012; 22:215-9. [PMID: 22678316 DOI: 10.1097/sle.0b013e31824ddda9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Surgery is accompanied by a surgical stress response, which results in increased morbidity and mortality. Oxidative stress is a part of the surgical stress response. Minimally invasive laparoscopic surgery may result in reduced oxidative stress compared with open surgery. Nineteen patients scheduled for sigmoid resection were randomly allocated to open or laparoscopic sigmoid resection in a double-blind, prospective clinical trial. Three biochemical markers of oxidative stress (malondialdehyde, ascorbic acid, and dehydroascorbic acid) were measured at 6 different time points (preoperatively, 1 h, 6 h, 24 h, 48 h, and 72 h postoperatively). There were no statistical significant differences between laparoscopic and open surgery for any of the 3 oxidative stress parameters. Malondialdehyde was reduced 1 hour postoperatively (P<0.001) for all 19 patients. There was a significant drop in ascorbic acid at 1 hour and 6 hours after the first abdominal incision (P=0.002) for all 19 patients. Laparoscopic surgery was not found to be associated with reduced oxidative stress.
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Vinha PP, Jordão AA, Farina JA, Vannucchi H, Marchini JS, Cunha SFDCD. Inflammatory and oxidative stress after surgery for the small area corrections of burn sequelae. Acta Cir Bras 2012; 26:320-4. [PMID: 21808847 DOI: 10.1590/s0102-86502011000400013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 03/15/2011] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To compare vitamin levels, inflammatory and oxidative stress markers before and after skin autograft surgery to correct burn scar areas. METHODS This prospective study was conducted with 8 patients with a median age of 28 years (range, 16 to 40 years) that had burn sequelae and were admitted to a Burn Unit for correction of small burn scar areas [3.3 (1.0-5.0) % of the corporal surface]. The volunteers were evaluated before and 48 hours after excision of scar tissue and skin autograft. Routine laboratory data, along with a food questionnaire and anthropometry were collected in the preoperative period. Serum vitamin A, C, E, B(12) and folic acid levels, inflammatory markers (C-protein reactive, alpha-1-acid glycoprotein, ferritin) and oxidative stress markers (reduced glutathione - GSH and Thiobarbituric Acid Reactive Substances - TBARS) were determined at preoperative and postoperative phases. Data were analyzed with two-sample Wilcoxon test. RESULTS All volunteers were clinically stable and had adequate nutritional status at admission. After surgery, C-reactive protein serum levels increased [0.4 (0.01-1.0) vs. 2.5 (0.6-4.7) mg/dL, p=0.01] and vitamin A levels decreased [3.4 (2.1-4.2) vs. 2.4 (1.6-4.1) µmol/L, p=0.01]. No changes occurred in other vitamins, ferrritin, alpha-1-acid glycoprotein, GSH and TBARS levels. CONCLUSION Minimal metabolic changes were produced after skin autograft in small areas of well-nourished patients without active infection or inflammation.
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Bulbuloglu E, Yildiz H, Senoglu N, Coskuner I, Yuzbasioglu MF, Kilinc M, Dogan Z, Deniz C, Oksuz H, Kantarçeken B, Atli Y. Protective Effects of Zinc, Pentoxifylline, and N-Acetylcysteine in an Animal Model of Laparoscopy-Induced Ischemia/Reperfusion Injury of the Small Intestine. J Laparoendosc Adv Surg Tech A 2011; 21:947-51. [DOI: 10.1089/lap.2011.0194] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Ertan Bulbuloglu
- Department of General Surgery, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Huseyin Yildiz
- Department of Anesthesiology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Nimet Senoglu
- Department of Anesthesiology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Ismail Coskuner
- Department of Anesthesiology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - M. Fatih Yuzbasioglu
- Department of General Surgery, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Metin Kilinc
- Department of Biochemistry, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Zafer Dogan
- Department of Anesthesiology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Caglayan Deniz
- Department of General Surgery, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Hafize Oksuz
- Department of Anesthesiology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Bulent Kantarçeken
- Department of Gastroenterology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Yalcın Atli
- Department of Biochemistry, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey
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Kıray S, Onalan G, Karabay G, Zeyneloglu H, Kuscu E. Antioxidant prophylaxis for cellular injury in ovarian surface epithelium resulting from CO₂ pneumoperitoneum in a laparoscopic rat model. Arch Gynecol Obstet 2011; 284:765-72. [PMID: 21617921 DOI: 10.1007/s00404-011-1933-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 05/05/2011] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Selective cytoprotective functions of vitamin E, N-acetyl-L: -cysteine, and amifostine have been used as a preventer of ischemia injury by expelling the free oxygen radicals leading to stabilization of the cellular membranes. The purpose of this experimental study was to investigate the oxidative stress related to cellular injury in ovarian surface epithelium and the effect of prophylaxis with an anti-oxidant using laparoscopic rat model. DESIGN Laparoscopic rat model. MATERIALS AND METHODS Randomly allocated 40 Wistar Albino female rats have been used for the pneumoperitoneum model which was constituted to fix the intraabdominal pressure on 5 mmHg for 60 min. The antioxidants, vitamin E and NAC were given to rats 3 days before the operation and were applied for 30 days; amifostine was applied 30 min before the operation until after for 7 days. After abdominal desufflation, over biopsies were made on the 13th min, 24th h, and 7th and 30th days. By using of transmission electron microscopy, the damage on cells and organels were assessed and graded. RESULTS In ovarian surface epithelium, the apical surface specializations were affected in all groups except Vit E group:The microvilli were irregular and coarse and had disappeared in some places. Some cells were separated from the epithelium. In addition, mitochondria degeneration was observed in all group except Vit E. CONCLUSIONS In the early period of laparoscopy, reversible cellular damage occurs and this damage can be prevented by vitamin E.
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Affiliation(s)
- Sule Kıray
- Department of Obstetrics and Gynecology, Baskent University School of Medicine, Kubilay Sok no: 36 Maltepe, 06570 Ankara, Turkey
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Arsalani-Zadeh R, Ullah S, Khan S, MacFie J. Oxidative stress in laparoscopic versus open abdominal surgery: a systematic review. J Surg Res 2011; 169:e59-68. [PMID: 21492871 DOI: 10.1016/j.jss.2011.01.038] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 12/13/2010] [Accepted: 01/20/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND Any form of trauma, including surgery, is known to result in oxidative stress. Increased intra-abdominal pressure during pneumoperitoneum and inflation-deflation may cause ischemia reperfusion and, hence, oxidative stress may be greater during laparoscopic surgery. The aim of this study was to systemically review the literature to compare oxidative stress in laparoscopic and open procedures. METHODS A systematic search of the Medline, Pub Med, EMBASE, and Cochrane databases was performed with the following keywords: pneumoperitoneum AND surger $ OR laparoscop $ AND oxida $. The search was limited to articles published between 1980 and August 2010. RESULTS The initial search identified 197 papers. After review of the abstracts, 17 papers met the inclusion criteria. Six more papers were identified through the reference lists. It was not possible to perform a meta-analysis due to heterogeneity of patient data, patient selection criteria, and diversity of biomarkers used. The majority of studies demonstrated greater immediate oxidative stress after open surgery. There was, however, a paucity of studies comparing open versus laparoscopic surgery with regards to tissue oxidative stress. CONCLUSION Laparoscopic surgery seems to produce less systemic oxidative stress. However the effect of pneumoperitoneum on local oxidative stress and tissue hypoxia and its clinical significance need further investigation.
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Chana F, Guisasola MC, Villanueva MJ, de las Heras J, Calvo JA, Vaquero J. Heat shock proteins in total knee arthroplasty. A pilot study. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s12570-010-0026-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Yu Y, Kuebler J, Groos S, Metzelder M, Kurpanik S, Ure BM, Vieten G. Carbon dioxide modifies the morphology and function of mesothelial cells and facilitates transepithelial neuroblastoma cell migration. Pediatr Surg Int 2010; 26:29-36. [PMID: 19847444 DOI: 10.1007/s00383-009-2503-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The response of mesothelial cells to surgical trauma and bacterial contamination is poorly defined. We have recently shown that CO(2) pneumoperitoneum increases systemic metastasis of neuroblastoma cells in a murine model. Thus, we hypothesized that CO(2) alters the morphology and function of mesothelial cells and facilitates transmesothelial tumor cell migration. MATERIALS AND METHODS Murine mesothelial cells were exposed to 100% CO(2) and 5% CO(2) as control. Scanning electron microscopy (SEM) investigations, as well as LPS-induced granulocyte-colony stimulating factor (G-CSF) production and mitochondrial activity (MTT assay) were measured. Transmesothelial migration of neuroblastoma cells (Neuro2a) was determined using a transwell chamber system. RESULTS CO(2) incubation was associated with a significant destruction of the microvillar formation in SEM. Migration studies showed that the barrier function of the mesothelial monolayer decreased. A significantly increased migration of neuroblastoma cells was identified after 100% CO(2) exposure (P < 0.05). Although the conversion of MTT as an indicator of mitochondrial activity was only slightly and not significantly reduced after CO(2) incubation, the release of G-CSF induced by LPS was completely blocked during the incubation with 100% CO(2) (P < 0.05). The capacity of G-CSF release recovered after the incubation. CONCLUSION We observed that peritoneal mesothelial cells lose their typical cell morphology by CO(2) incubation, which is accompanied by facilitated migration of neuroblastoma cells. Moreover, the synthesis of immunological factors is blocked, but this effect is not long lasting. These mechanisms may explain an increased metastasis rate of neuroblastoma cells after CO(2) pneumoperitoneum, which was recently observed in a murine model.
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Affiliation(s)
- Yi Yu
- Department of Pediatric Surgery, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
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Oksuz H, Bulbuloglu E, Senoglu N, Ciralik H, Yuzbasioglu MF, Kilinc M, Dogan Z, Goksu M, Yildiz H, Ozkan OV, Atli Y. Re-Protective Effects of Pre- and Post-Laparoscopy Conditioning, Zinc, Pentoxifylline, and N-acetylcysteine in an Animal Model of Laparoscopy-Induced Ischemia/Reperfusion Injury of the Kidney. Ren Fail 2009; 31:297-302. [DOI: 10.1080/08860220902780044] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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18
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Oxidative Stress in Relation to Surgery: Is There a Role for the Antioxidant Melatonin? J Surg Res 2009; 152:338-47. [DOI: 10.1016/j.jss.2007.12.753] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Revised: 09/25/2007] [Accepted: 12/06/2007] [Indexed: 01/12/2023]
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Arikan Y, Tosun M, Yilmaz S, Saykol V, Söylemez Z. The comparative effects of pneumoperitoneum on apoptosis and p53 expression in gastrointestinal organs. J Laparoendosc Adv Surg Tech A 2008; 18:365-71. [PMID: 18503368 DOI: 10.1089/lap.2007.0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Laparoscopic surgical techniques have been increasingly preferred to classic laparotomy by surgeons since 1987. The pneumoperitoneum is often used to facilitate the intra-abdominal field, but it carries the risk of its ischemic potential and has differences [l2]of metabolic, inflammatory, and infectious consequences, depending on the pressure set and kind of gas used. However, the mechanisms related with the cell injury observed after laparoscopy are still unknown. The aim of this study was to evaluate the effects of different pressures of CO(2) on apoptosis and p53 expression in small and large intestines and the stomach. MATERIALS AND METHODS In total, 30 Sprague-Dawley male rats were used in the study. CO(2) is insufflated into the intra-abdominal cavity through a angiocatheter cannule by an insufflator set at two different pressures of 10 and 20 mm Hg during 60 minutes. In the control group, the cannule was inserted into the intra-abdominal cavity without any other surgical procedure and no gas was insufflated. After 60 minutes, the rats were sacrificed and a laparotomy was performed. The small and large intestines and stomach were excised. The samples were histologically processed and an immunohistochemical analysis was performed. RESULTS The results of the study revealed that the number of apoptotic cells in intra-abdominal organs we studied increased in proportion to the CO(2) pressure level. However, the p53 expression was detected only in the stomach. CONCLUSIONS Our study showed that the number of apoptotic cells rises in parallel to the increase in intra-abdominal pressure following the CO(2) pneumoperitoneum in rat large and small intestine and stomach. Although the apoptosis was activated by the p53 pathway in the stomach, it was not so in the large and small intestine.
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Affiliation(s)
- Yüksel Arikan
- Department of General Surgery, The Faculty of Medicine, Afyonkarahisar Kocatepe University, Afyonkarahisar, Turkey
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Mesna protects splanchnic organs from oxidative stress induced by pneumoperitoneum. Surg Endosc 2008; 23:583-9. [PMID: 18368452 DOI: 10.1007/s00464-008-9887-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Revised: 01/14/2008] [Accepted: 02/02/2008] [Indexed: 12/17/2022]
Abstract
BACKGROUND We investigated the potential beneficial effect of the antioxidant 2-mercaptoethane-sulfonate (mesna) against oxidative stress induced by pneumoperitoneum in splanchnic organs. METHODS Wistar rats were subjected to either (a) CO(2) pneumoperitoneum (15 mmHg for 60 min) (group P), (b) pretreatment with mesna (400 mg/kg, p.o.) followed by pneumoperitoneum with a 180 min interval (group MP), (c) sham operation (group S), or (d) administration of mesna only (group M). Forty-five minutes after desufflation (groups P and MP), 60 + 45 min after the induction of anesthesia (group S), or 180 min after mesna administration (group M), tissue specimens were excised from liver, kidneys, jejunum and stomach. Tissue oxidative state was assessed on the basis of glutathione-to-glutathione disulfide ratio, malondialdehyde concentration , and superoxide dismutase activity. RESULTS Pneumoperitoneum deteriorated all the oxidative stress markers in the organs studied. Mesna prevented the occurrence of oxidative stress following pneumoperitoneum in all the organs studied. In the absence of pneumoperitoneum, the administration of mesna caused mild enhancement of the oxidative state of liver, stomach, and kidneys compared to sham controls. CONCLUSIONS Prophylaxis with mesna prevents oxidative stress induced by pneumoperitoneum in splanchnic organs.
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Kuebler JF, Kos M, Jesch NK, Metzelder ML, van der Zee DC, Bax KM, Vieten G, Ure BM. Carbon dioxide suppresses macrophage superoxide anion production independent of extracellular pH and mitochondrial activity. J Pediatr Surg 2007; 42:244-8. [PMID: 17208574 DOI: 10.1016/j.jpedsurg.2006.09.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Superoxide anions released by activated macrophages during surgery are considered to be responsible for local cellular damage. Application of CO2 pneumoperitoneum during laparoscopy affects superoxide anion release, but the underlying mechanism remains unclear and the data reported are conflicting. We investigated the direct and pH-mediated impact of CO2 and air on macrophage superoxide anion production. METHODS Cells of the NR 8383 rat macrophage cell line were incubated for 2 hours in 5% CO2, 100% CO2, and room air or pH 7.4, pH 6.5, and pH 5.5. The extracellular pH was monitored during incubation. At 0, 2, and 6 hours after incubation, the release of superoxide anions was determined fluorometrically. The mitochondrial activity was determined via the conversion of MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] during and after incubation. RESULTS Extracellular pH decreased to 6.4 during incubation in a CO2 atmosphere. The release of superoxide anions was significantly reduced immediately after CO2 incubation. It was restored at all other time-points. Decreasing the extracellular pH to 6.5 had no effect on superoxide anion release, whereas acidification of the extracellular milieu to pH 5.5 significantly suppressed subsequent superoxide release. Mitochondrial activity was significantly decreased by CO2 up to 2 hours and by acidic milieu up to 6 hours. Incubation in room air had no effect. CONCLUSIONS Incubation in CO2 can directly suppress macrophage superoxide anion production. This effect is of short duration, fully reversible, and not correlated to changes in extracellular pH or mitochondrial activity. Air contamination does not affect macrophage superoxide anion release. We speculate that CO2 pneumoperitoneum could attenuate the intraoperative free radical production by directly inhibiting superoxide anion release of macrophages without long-lasting suppression of macrophages and their capacity to release superoxide anions postoperatively.
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Affiliation(s)
- Joachim F Kuebler
- Department of Pediatric Surgery, Hannover Medical School, Hannover 30625, Germany
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Altindis M, Yilmaz S, Polat C, Serteser M. Sequential periods of preconditioning decrease laparoscopy-related elevations in hepatic TNF-alpha and IL-6 levels in rats. J Laparoendosc Adv Surg Tech A 2005; 14:380-3. [PMID: 15684786 DOI: 10.1089/lap.2004.14.380] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Laparoscopy induces an ischemia/reperfusion (I/R) injury that elicits the production of inflammatory cytokines. The aim of this study was to test whether laparoscopic preconditioning (LP) could change hepatic inflammatory response. MATERIALS AND METHODS Twenty-four male Spraque Dawley rats were assigned into one of three experimental groups: the control group (C) was subjected to sham operation; the I/R group was subjected to 60 minutes of pneumoperitoneum followed by 45 minutes of desufflation; and the ischemic preconditioning (IP) group was subjected to preconditioning prior to the induction of I/R. Preconditioning was defined as two cycles of 5 minutes of pneumoperitoneum followed immediately by 5 minutes of desufflation. Hepatic tumor necrosis factor alpha (TNF-alpha) and interleukin (IL)-6 levels were evaluated as an inflammatory response. RESULTS Hepatic TNF-alpha levels increased in the I/R group compared with the C group (9.64 +/- 0.77 pg/mg protein vs. 6.53 +/- 0.48 pg/mg protein, P < 0.01). The decreased TNF-alpha levels in the IP group were not statistically significant when compared to the I/R group (8.09 +/- 0.74 pg/mg protein). Hepatic IL-6 levels increased in the I/R group compared to the C group (4.17 +/- 0.31 pg/mg protein vs. 2.93 +/- 0.20 pg/mg, P < 0.05). IP reduced the hepatic IL-6 levels significantly compared to the I/R group (3.31 +/- 0.22 pg/mg protein vs. 4.17 +/- 0.31 pg/mg protein, P <0.05). CONCLUSION Laparoscopy induces cytokine response in various organs including the liver. LP could alter the production of cytokines prior to sustained laparoscopic procedures. Preconditioning may be advisable, especially for elderly or other patients with hepatic, renal, or cardiac dysfunction. Further studies are needed to adapt this concept to clinical settings.
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Affiliation(s)
- Mustafa Altindis
- Department of Microbiology, Afyon Kocatepe University School of Medicine, Afyon, Turkey
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Ruzic B, Tomaskovic I, Trnski D, Kraus O, Bekavac-Beslin M, Vrkic N. Systemic stress responses in patients undergoing surgery for benign prostatic hyperplasia. BJU Int 2005; 95:77-80. [PMID: 15638899 DOI: 10.1111/j.1464-410x.2004.05276.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine differences in systemic stress responses in patients undergoing three different types of surgery for benign prostatic hyperplasia (BPH), evaluated by measuring levels of stress variables, i.e. cortisol; acute-phase reactants, i.e. C-reactive protein (CRP) and fibrinogen; and antioxidants, i.e. total antioxidant status (TAS) and superoxide dismutase (SOD). PATIENTS AND METHODS The study included 80 patients who fulfilled the inclusion criteria for surgery for BPH. Based on an ultrasonographic estimate of the prostate volume before surgery, all patients were allocated to one of three groups; group 1, prostate < or = 30 g and treated with transurethral incision of the prostate (TUIP); group 2, prostate 30-80 g, treated with transurethral resection of the prostate (TURP); and group 3, prostate >80 g, treated with a suprapubic transvesical prostatectomy (TP). Blood samples were taken from each patient on the day before and the day after surgery, and the acute-phase reactants and antioxidants measured; cortisol concentrations were also measured in 24-h urine samples the day before and 3 days after surgery. RESULTS There were significantly higher levels of cortisol, CRP and TAS, and significantly lower levels of fibrinogen and SOD in all study groups after surgery than before. Surgery and associated conditions, e.g. excitement, fear, blood loss, etc., lead to traumatic and oxidative stress, followed by a strong systemic stress response during and after surgery. Low fibrinogen levels after surgery had a different pattern from the other acute-phase reactants, as a result of increased fibrinolytic activity after TURP and TP. CONCLUSION The extent of the systemic stress response correlated fairly well with the degree of tissue damage, which differed in the three groups. Suprapubic TP caused the most tissue trauma and triggered the strongest systemic stress response. This response was moderate after TURP, while TUIP (a minor intervention) caused the least stress. Specific changes in stress markers could be used to improve surgery for BPH. Whether there is a benefit of antioxidant therapy during surgery for BPH should be evaluated in further studies.
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Affiliation(s)
- Boris Ruzic
- Department of Urology, University of Zagreb, University Hospital Sisters of Mercy, Vinogradska cesta 29, 10000 Zagreb, Croatia.
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Papaziogas B, Koutelidakis IM, Giamarellos-Bourboulis EJ, Lazaridis C, Koussoulas V, Galanis I, Giamarellou H, Atmatzidis K. Lipid peroxidation and inguinal hernia repair. Tension-free vs. Andrews technique. Prostaglandins Leukot Essent Fatty Acids 2004; 71:221-5. [PMID: 15301792 DOI: 10.1016/j.plefa.2004.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2004] [Accepted: 03/29/2004] [Indexed: 11/26/2022]
Abstract
AIM OF THE STUDY To evaluate the early effect of inguinal hernia repair by the tension-free method compared to the conventional Andrew's technique on lipid peroxidation. PATIENTS-METHODS Thirty-four patients subjected to elective hernia repair were enrolled in the study divided in two groups. Group A (n=18) underwent hernia repair by the tension-free method using a polypropylene mesh. Group B (n=16) underwent hernia repair by the Andrew's technique (i.e. a modification of the Bassini's technique). Venous blood samples were drawn preoperatively and at 12, 24 and 48 h postoperatively. Malondialdehyde (MDA) was estimated by the thiobarbiturate assay. RESULTS Neutrophil counts were significantly higher in patients of group B compared to group A at 12 and 48 h postoperatively. Concentrations of fibrinogen were similar between the two groups. MDA was significantly higher in patients of group B hours compared to group A at 12, 24 and 48 h postoperatively. Positive correlation was found between neutrophil counts and MDA at 12 h (r: +0.43, P: 0.015) and 48 h (r: +0.496, P: 0.005) but not at 24 h. No correlation was found between serum fibrinogen and MDA. CONCLUSION Hernia repair by the Andrews's technique elicits a sustained triggering of lipid peroxidation, compared to the tension-free method.
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Affiliation(s)
- Basilios Papaziogas
- Department of Surgery, Aristotle University of Thessaloniki, Medical School, Fanariou 17 Kalamaria, 55133 Thessaloniki, Greece
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Yilmaz S, Polat C, Kahraman A, Koken T, Arikan Y, Dilek ON, Gökçe O. The Comparison of the Oxidative Stress Effects of Different Gases and Intra-abdominal Pressures in an Experimental Rat Model. J Laparoendosc Adv Surg Tech A 2004; 14:165-8. [PMID: 15245669 DOI: 10.1089/1092642041255450] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Laparoscopy is used for almost all types of abdominal surgery because of its advantages, which include shorter postoperative hospital stay. However, pneumoperitoneum used to facilitate the visual field has severe metabolic, hemodynamic, and inflammatory consequences depending on the pressure level and the gas used. Helium (He), an inert gas, has been recommended for establishment of pneumoperitoneum since it does not alter the blood pH and PCO(2). Yet the oxidative response after He insufflation remains unknown. This study was undertaken to compare the levels of free radical production and antioxidant status following He and CO(2) pneumoperitoneum at different intra-abdominal pressure values. MATERIALS AND METHODS The subjects were 40 Sprague-Dawley male rats randomized to the following groups: He 10 (n = 8) was subjected to He pneumoperitoneum at 10 mm Hg for 60 minutes; He 15 (n = 8) was subjected to He pneumoperitoneum at 15 mm Hg for 60 minutes; CO(2) 10 (n = 8) was subjected to CO(2) pneumoperitoneum at 10 mm Hg for 60 minutes; CO(2) 15 (n = 8) was subjected to CO(2) pneumoperitoneum at 15 mm Hg for 60 minutes; and Control (n = 8) was subjected to sham operation without pneumoperitoneum. At the end of the experiment blood samples were obtained and plasma malondialdehyde, carbonyl, and sulphydryl levels were measured. RESULTS CO(2) pneumoperitoneum produced higher malondialdehyde and carbonyl responses and sulphydryl consumption compared to He, especially at 15 mm Hg (P = 0.01, P = 0.01, and P = 0.059, respectively). CONCLUSION Helium seems to limit the postoperative oxidative response following laparoscopy.
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Affiliation(s)
- Sezein Yilmaz
- Faculty of Medicine, General Surgery, Afyon Kocatepe University, Afyon, Turkey.
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