Guler Cem, Demirbas Murat, Samli Murat, Koken Tulay, Kahraman Ahmet, Dincel Cetin
Department of Urology, The Faculty of Medicine, Afyon Kocatepe University, Afyon 03200, Turkey.
J Endourol. 2003 Dec;17(10):935-9. doi: 10.1089/089277903772036325.
Laparoscopic donor nephrectomy causes increased renal oxidative stress. There are no data about the effects of the retroperitoneoscopic route. The aim of our study was to evaluate the oxidative stress occurring in renal tissues during retroperitoneoscopic donor nephrectomy in a rabbit model.
Eighteen adult rabbits were randomized to three groups, each consisting of six rabbits. Group I (control) underwent 50-mL balloon dissection of the left retroperitoneal space without CO(2) insufflation. Group II (pneumoretroperitoneum) received a 3-hour CO(2) insufflation at a pressure of 10 mm Hg in the retroperitoneal space after balloon dissection. Group III (pneumoretroperitoneum with warm ischemia), in addition to the procedure applied in Group II, underwent left renal artery clamping for 3 minutes and reperfusion for the next 5 minutes. Bilateral nephrectomy was performed in all animals for analysis of oxidative stress markers. Concentrations of malonyldialdehyde (MDA), protein carbonyl, and reduced glutathione (GSH) were measured in renal tissue samples.
The MDA and protein carbonyl content were increased both in the donor (P = 0.004 and P = 0.004, respectively) and in the remaining kidneys (P = 0.009 and P = 0.028, respectively) in Group II compared with Group I. There were no statistically significant increases in oxidative stress markers between Group II and Group III in donor kidneys. However, there were statistically significant decreases in MDA in the remaining kidneys in Group III compared with Group II (P = 0.009).
Pneumoretroperitoneum causes increased oxidative stress in both donor and remaining kidneys. Short-term warm ischemia and reperfusion do not exert an additive effect on pneumoretroperitoneum-associated oxidative stress in donor kidneys.
腹腔镜供肾切除术会导致肾脏氧化应激增加。目前尚无关于后腹腔镜途径影响的数据。我们研究的目的是评估兔模型后腹腔镜供肾切除术中肾组织发生的氧化应激。
18只成年兔随机分为三组，每组6只。第一组（对照组）在不注入二氧化碳的情况下对左腹膜后间隙进行50毫升球囊分离。第二组（腹膜后充气）在球囊分离后，于腹膜后间隙以10毫米汞柱的压力进行3小时二氧化碳充气。第三组（腹膜后充气伴热缺血）除了进行第二组的操作外，左肾动脉夹闭3分钟，随后再灌注5分钟。对所有动物进行双侧肾切除术以分析氧化应激标志物。测量肾组织样本中丙二醛（MDA）、蛋白质羰基和还原型谷胱甘肽（GSH）的浓度。
与第一组相比，第二组供肾（分别为P = 0.004和P = 0.004）及剩余肾脏（分别为P = 0.009和P = 0.028）中的MDA和蛋白质羰基含量均增加。第二组和第三组供肾的氧化应激标志物之间无统计学显著增加。然而，与第二组相比，第三组剩余肾脏中的MDA有统计学显著降低（P = 0.009）。
腹膜后充气会导致供肾和剩余肾脏的氧化应激增加。短期热缺血和再灌注对供肾中与腹膜后充气相关的氧化应激无叠加作用。
