Effects of different intraabdominal pressure levels on oxidative stress markers in laparoscopic cholecystectomy
Uğur Doğan1
, Mani Habibi2, Nurullah Bülbüller3, Hamit Yaşar Ellidağ4, Burhan Mayir1, Tuğrul Çakır1, Arif Aslaner1, Ümit Koç1, İsmail Gömceli1, Mehmet Tahir Oruç1
1Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey
2Department of General Surgery Alanya Training and Research Hospital, Antalya, Turkey
3Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
4Central Laboratories, Antalya Training and Research Hospital, Antalya, Turkey
Abstract
Objective: To evaluate the effect of laparoscopic cholecystectomy performed under different intraabdominal pressure on oxidative stress markers.
Material and Methods: This prospective, randomized, controlled study examined 90 consecutive healthy patients who underwent elective laparoscopic cholecystectomy with the diagnosis of symptomatic cholelithiasis. The patients were divided into three groups, 30 patients in each. Group 1 included patients who underwent laparoscopic cholecystectomy at a CO2 pneumoperitoneum pressure of 7 mmHg, Group 2 patients who underwent laparoscopic cholecystectomy at a CO2 pneumoperitoneum pressure of 10 mmHg, and Group 3 patients who underwent laparoscopic cholecystectomy at a CO2 pneumoperitoneum pressure of 13 mmHg. Blood samples were collected preoperatively, perioperatively, and postoperatively for measurement of the serum levels of ischemia modified albumin and an analysis of total antioxidant status and total oxidant status. Intra-group comparisons were made.
Results: Group 1 experienced a significant increase in the postoperative ischemia modified albumin values compared to preoperative ischemia modified albumin values (p=0.013). Group 2 experienced a significant decrease in the perioperative total antioxidant status values compared to preoperative and postoperative total antioxidant status values (p=0.009). Group 3 experienced a significant increase in the perioperative total oxidant status and oxidative stress index values compared to preoperative values (p<0.001). Group 3 experienced a significant increase in the perioperative and postoperative ischemia modified albumin values compared to preoperative values (p<0.001).
Conclusion: Increased levels of oxidative stress markers were detected in patients who underwent laparoscopic cholecystectomy at a high intraabdominal pressure level.
Keywords: Antioxidant, intraabdominal pressure, laparoscopic cholecystectomy, oxidative stress, pneumoperitoneum
Cite this paper as: Doğan U, Habibi M, Bulbuller N, Ellidağ HY, Mayir B, Çakır T, et al. Effects of different intraabdominal pressure levels on oxidative stress markers in laparoscopic cholecystectomy. Turk J Surg 2018; 10.5152/turkjsurg.2017.3906.
This study was presented at the “23rd International Congress of the European Association for Endoscopic Surgery (EAES)”, “3-6 June 2015”, ‘’Bucharest, Romania’’.
Ethics committee approval was received for this study from the Ethics Committee of Antalya Training and Research Hospital (2013-162).
Written informed consent was obtained from patient who participated in this study
Externally peer-reviewed.
Concept - U.D., I.G., M.H., U.K.; Design - U.D., I.G., N.B.; Supervision - U.D., N.B., B.M., M.T.O.; Resource - U.D., H.Y.E., B.M.; Materials - U.D., H.Y.E., U.K., T.C.; Data Collection and/or Processing - U.D., T.C., A.A.; Analysis and/or Interpretation - U.D., B.M., M.H.; Literature Search - U.D., U.K., M.T.O.; Writing Manuscript - U.D., M.H., H.Y.E.; Critical Reviews - U.D., B.M., N.B.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.