Madsen Michael Tvilling, Kücükakin Bülent, Lykkesfeldt Jens, Rosenberg Jacob, Gögenur Ismail
Department of Surgical Gastroenterology, University of Copenhagen, Herlev Hospital, Herlev, Denmark.
Surg Laparosc Endosc Percutan Tech. 2012 Jun;22(3):215-9. doi: 10.1097/SLE.0b013e31824ddda9.
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.
手术伴随着手术应激反应，这会导致发病率和死亡率增加。氧化应激是手术应激反应的一部分。与开放手术相比，微创腹腔镜手术可能会降低氧化应激。在一项双盲、前瞻性临床试验中，将19例计划进行乙状结肠切除术的患者随机分配至开放或腹腔镜乙状结肠切除术组。在6个不同时间点（术前、术后1小时、6小时、24小时、48小时和72小时）测量氧化应激的三种生化标志物（丙二醛、抗坏血酸和脱氢抗坏血酸）。对于这3种氧化应激参数中的任何一种，腹腔镜手术和开放手术之间均无统计学显著差异。所有19例患者术后1小时丙二醛水平均降低（P<0.001）。所有19例患者在首次腹部切口后1小时和6小时抗坏血酸水平均显著下降（P=0.002）。未发现腹腔镜手术与氧化应激降低相关。
