Koźlik Jacek, Przybyłowska Joanna, Mikrut Kinga, Żukiewicz-Sobczak Wioletta A, Zwoliński Jacek, Piątek Jacek, Sobczak Paweł
Department of Physiology, Poznan University of Medical Sciences, Poznan, Poland ; Department of Gynecology and Obstetrics, F. Raszeja Hospital, Poznan, Poland.
Department of Gynecology and Obstetrics, F. Raszeja Hospital, Poznan, Poland.
Wideochir Inne Tech Maloinwazyjne. 2015 Apr;10(1):92-100. doi: 10.5114/wiitm.2014.47449. Epub 2014 Dec 4.
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.
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.
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.
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.
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.
与开放手术相比,腹腔镜手术后的手术应激反应较小,预计微创手术后氧化应激的可能发展程度会较轻。
评估妇科腹腔镜手术患者围手术期促氧化活性标志物——脂质过氧化物和丙二醛水平,以及抗氧化酶超氧化物歧化酶和谷胱甘肽过氧化物酶的活性,并确定腹腔镜手术时间是否会影响这些变化。
该研究纳入64例患者,分为两组:第1组腹腔镜手术时间长达20分钟,第2组手术时间超过40分钟。在麻醉前、气腹解除后5分钟和术后10小时采集血样。
与术前值相比,术后采集的样本中脂质过氧化物和丙二醛水平有统计学意义的升高。不同手术时间的患者组之间也存在统计学意义的差异。超氧化物歧化酶和谷胱甘肽过氧化物酶活性值显著降低。不同手术时间的两组之间也有显著差异。
在我们的研究中,促氧化活性标志物水平升高,抗氧化酶标志物水平降低,提示氧化应激的发生。腹腔镜手术时间影响所呈现变化的严重程度。