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Selected oxidative stress markers in gynecological laparoscopy. Wideochir Inne Tech Maloinwazyjne 2014; 10:92-100. [PMID: 25960799 PMCID: PMC4414094 DOI: 10.5114/wiitm.2014.47449] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 10/18/2014] [Accepted: 10/26/2014] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The surgical stress response after laparoscopy is smaller when compared with open surgery, and it is expected that after minimally invasive surgery the possible development of oxidative stress will be less severe. AIM To evaluate markers of pro-oxidant activity - levels of lipid peroxides and malondialdehyde - and activity of the antioxidant enzymes superoxide dismutase and glutathione peroxidase in the perioperative period in patients undergoing gynecological laparoscopy and to determine whether the duration of laparoscopy can affect these changes. MATERIAL AND METHODS The study included 64 patients, divided into two groups: group 1 with duration of laparoscopy up to 20 min, and group 2 with duration of the operation over 40 min. Blood samples were collected before anesthesia, 5 min after release of pneumoperitoneum, and 10 h after surgery. RESULTS A statistically significant increase in the levels of lipid peroxides and malondialdehyde in samples collected after surgery was found in comparison with values obtained before surgery. Also statistically significant differences existed between groups of patients with different duration of surgery. Superoxide dismutase and glutathione peroxidase activity values were significantly decreased. They were also significantly different between the two groups with different duration of surgery. CONCLUSIONS In our study, levels of the markers of pro-oxidant activity increased and levels of the markers of antioxidant enzymes decreased, suggesting development of oxidative stress. The duration of laparoscopic procedures affects the severity of the presented changes.
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Pappas-Gogos G, Tellis CC, Trypsianis G, Tsimogiannis KE, Tsimoyiannis EC, Simopoulos CE, Pitiakoudis M, Tselepis AD. Oxidative stress in multi-port and single-port cholecystectomy. J Surg Res 2014; 194:101-6. [PMID: 25438954 DOI: 10.1016/j.jss.2014.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 08/14/2014] [Accepted: 09/18/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study was designed to analyze and compare plasma levels of 8-isoprostane (8-epiPGF2α), a biomarker of lipid peroxidation, and uric acid (UA), a marker of the antioxidant status, in standard laparoscopic (LC) and laparoendoscopic single-site cholecystectomy (LSSC). MATERIALS AND METHODS Forty patients with noncomplicated cholelithiasis were randomized to undergo either LSSC (n = 20) or LC (n = 20). The patients had body mass index <30, American Society of Anesthesiologists score I or II, and no previous upper gastrointestinal surgery. Blood samples were taken preoperatively and 6 h and 24 h postoperatively. Levels of 8-epiPGF2α were determined using enzyme-linked immunosorbent assay, whereas levels of UA were calculated using automated analyzer. RESULTS No significant differences were observed in operative data among the groups. Levels of 8-epiPGF2α were significantly higher in LSSC compared with LC at 6 h (P = 0.003) and 24 h (P < 0.001). 8-epiPGF2α levels showed significant changes over time in LC (LSSC: P = 0.720, LC: P < 0.001). UA levels were significantly higher in LC compared with LSSC, 24 h postoperatively (P = 0.021). No significant changes over time in the UA levels in both groups (LSSC: P = 0.056, LC: P = 0.205). CONCLUSIONS LSSC is associated with increased oxidative stress compared with LC. Further studies are needed to confirm these results.
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Affiliation(s)
- George Pappas-Gogos
- Department of Surgery, "G. Hatzikosta" General Hospital of Ioannina, Ioannina, Greece.
| | - Constantinos C Tellis
- Chemistry Department, Laboratory of Biochemistry, Ioannina University, Ioannina, Greece
| | - Grigorios Trypsianis
- Department of Statistics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | | | | | - Michael Pitiakoudis
- Department of Surgery, Democritus University of Thrace, Alexandroupolis, Greece
| | - Alexandros D Tselepis
- Chemistry Department, Laboratory of Biochemistry, Ioannina University, Ioannina, Greece
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Sofra M, Antenucci A, Gallucci M, Mandoj C, Papalia R, Claroni C, Monteferrante I, Torregiani G, Gianaroli V, Sperduti I, Tomao L, Forastiere E. Perioperative changes in pro and anticoagulant factors in prostate cancer patients undergoing laparoscopic and robotic radical prostatectomy with different anaesthetic techniques. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2014; 33:63. [PMID: 25129475 PMCID: PMC4431486 DOI: 10.1186/s13046-014-0063-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 07/15/2014] [Indexed: 12/26/2022]
Abstract
BACKGROUND Laparoscopic prostatectomy (LRP) may activate clotting system influencing the risk of perioperative thrombosis in patients with prostate cancer. Moreover, different anaesthetic techniques can also modify coagulant factors. Thus, the aim of this study was to investigate the effects on pro- and anti-coagulant and fibrinolytic factors of two established types of anaesthesia in patients with prostate cancer undergoing elective LRP. METHODS 102 patients with primary prostate cancer, who underwent conventional LRP or robot-assisted laparoscopic prostatectomy (RALP), were studied and divided into 2 groups to receive total intravenous anesthesia with target-controlled infusion (TIVA-TCI) or balanced inhalation anaesthesia (BAL) prior to surgery. Before the induction of anaesthesia (T0), 1 hr (T1) and 24 hrs post-surgery (T2), some pro-coagulant factors, fibronolysis markers, p-selectin and haemostatic system inhibitors were evaluated. RESULTS Both TIVA-TCI and BAL patients showed a marked and significant increase in pro-coagulant factors and consequent reduction in haemostatic system inhibitors in the early post operative period (p ≤ 0.004 for each markers). Use of RALP showed a significant increase in prothrombotic markers as compared to LRP. In TIVA patients undergoing LRP, a significant reduction of p-selectin levels between T0 and T2 (p = 0.001) was observed as compared to BAL, suggesting a better protective effect on platelet activation of anaesthetic agents used for TIVA. CONCLUSIONS Both anaesthetic techniques significantly seem to increase the risk of thrombosis in prostate cancer patients undergoing LRP, mainly when the robotic device was utilized, encouraging the use of a peri-operative thromboembolic prophylaxis in these patients.
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Affiliation(s)
- Maria Sofra
- Department of Anaesthesiology, Regina Elena, Roma National Cancer Institute, Via Elio Chianesi 53, Roma, 00144, Italy.
| | - Anna Antenucci
- Clinical Pathology, Regina Elena, Roma National Cancer Institute, Rome, Italy.
| | - Michele Gallucci
- Department of Urology, Regina Elena, Roma National Cancer Institute, Rome, Italy.
| | - Chiara Mandoj
- Clinical Pathology, Regina Elena, Roma National Cancer Institute, Rome, Italy.
| | - Rocco Papalia
- Department of Urology, Regina Elena, Roma National Cancer Institute, Rome, Italy.
| | - Claudia Claroni
- Department of Anaesthesiology, Regina Elena, Roma National Cancer Institute, Via Elio Chianesi 53, Roma, 00144, Italy.
| | - Ilaria Monteferrante
- Department of Anaesthesiology, Regina Elena, Roma National Cancer Institute, Via Elio Chianesi 53, Roma, 00144, Italy.
| | - Giulia Torregiani
- Department of Anaesthesiology, Regina Elena, Roma National Cancer Institute, Via Elio Chianesi 53, Roma, 00144, Italy.
| | - Valeria Gianaroli
- Department of Anaesthesiology, Regina Elena, Roma National Cancer Institute, Via Elio Chianesi 53, Roma, 00144, Italy.
| | - Isabella Sperduti
- Division of Biostatistic, Regina Elena, Roma National Cancer Institute, Rome, Italy.
| | - Luigi Tomao
- Clinical Pathology, Regina Elena, Roma National Cancer Institute, Rome, Italy.
| | - Ester Forastiere
- Department of Anaesthesiology, Regina Elena, Roma National Cancer Institute, Via Elio Chianesi 53, Roma, 00144, Italy.
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Effects of open versus laparoscopic nephrectomy techniques on oxidative stress markers in patients with renal cell carcinoma. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2013; 2013:438321. [PMID: 23533691 PMCID: PMC3596928 DOI: 10.1155/2013/438321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/14/2013] [Indexed: 11/18/2022]
Abstract
The aim of the study was to determine the concentration of lipid peroxidation products, the activity of selected antioxidant and lysosomal enzymes, and protease inhibitor in patients with renal cell carcinoma who underwent radical nephrectomy. The studied group included 44 patients: 21 of them underwent open surgery, while 23 underwent laparoscopy. Blood samples were collected three times: before treatment and 12 hours and five days after nephrectomy. In blood of participants, the concentration of thiobarbituric acid reactive substances (TBARS), the activity of catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx), and the activity of acid phosphatase (AcP), arylsulfatase (ASA), cathepsin D (CTSD), and α 1-antitrypsin (AAT) were assayed. No statistically significant differences in investigated parameters were found between studied groups. Moreover, TBARS concentration and CAT, SOD, and GPx activity were not altered in the course of both types of surgery. Five days after both open and laparoscopic nephrectomy techniques, AAT activity was higher than its activity 12 hours after the procedure. The obtained results suggest that laparoscopy may be used for nephrectomy as effectively as open surgery without creating greater oxidative stress. Reduced period of convalescence at patients treated with laparoscopy may be due to less severe response of acute-phase proteins.
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Oxidative stress markers in laparoscopic versus open colectomy for cancer: a double-blind randomized study. Surg Endosc 2013; 27:2357-65. [DOI: 10.1007/s00464-013-2788-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 01/07/2013] [Indexed: 02/06/2023]
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Elevation of Liver Function Tests After Laparoscopic Gastrectomy Using a Nathanson Liver Retractor. World J Surg 2011; 35:2730-8. [DOI: 10.1007/s00268-011-1301-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Luo CF, Tsai YF, Chang CH, Wu CT, Yu HP. Increased oxidative stress and gut ischemia caused by prolonged pneumoperitoneum in patients undergoing robot-assisted laparoscopic radical prostatectomy. ACTA ACUST UNITED AC 2011; 49:46-9. [PMID: 21729809 DOI: 10.1016/j.aat.2011.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 04/28/2011] [Accepted: 05/04/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate changes in plasma oxidative stress markers associated with prolonged pneumoperitoneum during robot-assisted laparoscopic radical prostatectomy (RALP). METHODS In all, patients of ASA Physical Status II-III who intended to undergo RALP were enrolled in the study. Arterial plasma levels of malondialdehyde (MDA) and intramucosal pH were measured 1 minute before and at 1 hour, 2 hours, 3 hours, and 4 hours after the introduction of pneumoperitoneum at an insufflation pressure of 15 mmHg; likewise, they were again measured every 10 minutes after deflation for 60 minutes, at 2 hours and 12 hours after deflation. RESULTS The mean duration of pneumoperitoneum was around 4 hours. After induction of pneumoperitoneum, the MDA concentrations were significantly elevated at various time points as compared with the preinsufflation value. Significant increase of MDA value was noted also 30 minutes after deflation as compared with the pre-deflation levels. The intramucosal pH value decreased significantly after CO(2) insufflation compared with the preinsufflation values. It also increased significantly 2 hours after CO(2) deflation as compared with the pre-deflation values. CONCLUSION A prolonged pneumoperitoneum in RALP results in decreased splanchnic blood flow. Pneumoperitoneum itself produces oxidative stress, and ischemia-reperfusion model after deflation of pneumoperitoneum produces more oxidative stress.
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Affiliation(s)
- Chiao-Fen Luo
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
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Ildefonso JÁ, Arias-Díaz J. Fisiopatología de la lesión hepática por isquemia-reperfusión. Cir Esp 2010; 87:202-9. [DOI: 10.1016/j.ciresp.2009.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Accepted: 11/10/2009] [Indexed: 12/18/2022]
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Sammour T, Mittal A, Loveday BPT, Kahokehr A, Phillips ARJ, Windsor JA, Hill AG. Systematic review of oxidative stress associated with pneumoperitoneum. Br J Surg 2009; 96:836-50. [DOI: 10.1002/bjs.6651] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Abstract
Background
There have been several reports of ischaemic complications after routine laparoscopy. The aim of this review was to investigate the relationship between this oxidative stress and pneumoperitoneum.
Methods
Medline, Medline in-process, The Cochrane Library, PubMed and EMBASE were searched for papers on oxidative stress and pneumoperitoneum, from 1947 to March 2008 with no language restriction or restriction on trial design. Papers that did not investigate pneumoperitoneum as a causative factor, or did not report outcome measures related to oxidative stress, were excluded.
Results
A total of 73 relevant papers were identified: 36 animal studies, 21 human clinical trials, nine case reports, five review articles and two comments. Pneumoperitoneum causes a reduction in splanchnic blood flow, resulting in biochemical evidence of oxidative stress in a pressure- and time-dependent manner. There is evidence that the use of carbon dioxide for insufflation is contributory. Several measures proposed to minimize the oxidative stress have shown promise in animal studies, but few have been evaluated in the clinical setting.
Conclusion
There is an increasing body of evidence, mainly from animal studies, that pneumoperitoneum decreases splanchnic perfusion with resulting oxidative stress. It is now appropriate to investigate the clinical significance of pneumoperitoneum-associated oxidative stress.
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Affiliation(s)
- T Sammour
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A Mittal
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - B P T Loveday
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A Kahokehr
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A R J Phillips
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - J A Windsor
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A G Hill
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Morris-Stiff G, Jones R, Mitchell S, Barton K, Hassn A. Retraction transaminitis: an inevitable but benign complication of laparoscopic fundoplication. World J Surg 2009; 32:2650-4. [PMID: 18825455 DOI: 10.1007/s00268-008-9744-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Transient transaminitis has been identified following laparoscopic abdominal surgery. However, the importance of posture, duration of surgery, and mechanical retraction in its etiology remain unclear. METHODS Liver function was assessed preoperatively then at 8, 24, 48 and 72 h following laparoscopic surgery including the following procedures: Nissen fundoplication (LN: n = 10); cholecystectomy (LC: n = 10); inguinal herniorrhaphy (LH: n = 10); and gastrectomy (LG: n = 5). RESULTS Aspartate aminotransferase (AST) levels in LN patients exhibited a rapid rise within 8 h, peaking at 48 h before returning toward baseline. In the LN group, AST levels were significantly higher at 8 h and 24 hours compared to all other groups and compared to LG at 48 h and 72 h. At 6-week follow-up all AST levels were normal. No significant differences were seen in other hepatic parameters, and no correlation between AST and duration of operation, gender, or age was identified. CONCLUSIONS Antireflux surgery is associated with transaminitis related to hepatic retraction, which is independent of patient posture or duration of observation, and it resolves spontaneously with no clinical consequences.
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Affiliation(s)
- Gareth Morris-Stiff
- Department of Surgery, Princess of Wales Hospital, Coity Road, Bridgend, CF31 1RQ, Wales, UK.
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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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