Mijatović Srdjan, Alempijević Tamara, Stefanović Branislava, Jeremić Vasilije, Krstić Slobodan, Radmanović Nikola, Jovanović Sanja, Stefanović Branislav
Clinic for Emergency Surgery, Clinical Centre of Serbia, Belgrade, Serbia.
School of Medicine, University of Belgrade, Belgrade, Serbia.
J Med Biochem. 2017 Apr 22;36(2):171-176. doi: 10.1515/jomb-2017-0004. eCollection 2017 Apr.
Oxidative stress represents tissue damage caused by reactive forms of oxygen and nitrogen due to the inability of antioxidant mechanisms to reduce reactive forms into more stable ones. The aim of the study was to evaluate the influence of surgical trauma on nitric oxide (NO) and nitrotyrosine (NT) values in patients undergoing conventional and laparoscopic cholecystectomy.
A prospective study included sixty patients from the Department of Emergency Surgery, Clinical Centre of Serbia who were operated for gallstone related chronic cholecystitis. All the patients enrolled in the study underwent cholecystectomy; the first group was operated conventionally (30 patients - control group), while the second group was operated laparoscopically (30 patients - treatment group).
There were no statistically significant differences in the values of NO and its postoperative changes in both groups, the conventionally operated group (p=0.943) and the laparoscopically operated group (p=0.393). We found an increase in NT values 24 hours postoperatively (p=0.000) in the conventionally operated patients, while in the group operated laparoscopically we didn't find statistically significant changes in the values of NT (conventionally operated group (p=0.943) and laparoscopically operated group (p=0.393)).
In our study, we found a significant increase in NT values 24 hours postoperatively in conventionally operated patients i.e. the control group, vs. the treatment group. Further randomized studies are needed for a better understanding of the impact of surgical trauma on oxidative stress response.
氧化应激是指由于抗氧化机制无法将活性形式的氧和氮还原为更稳定的形式而导致的组织损伤。本研究的目的是评估手术创伤对接受传统开腹胆囊切除术和腹腔镜胆囊切除术患者一氧化氮(NO)和硝基酪氨酸(NT)值的影响。
一项前瞻性研究纳入了塞尔维亚临床中心急诊外科的60例因胆结石相关慢性胆囊炎接受手术的患者。所有纳入研究的患者均接受了胆囊切除术;第一组采用传统开腹手术(30例患者——对照组),而第二组采用腹腔镜手术(30例患者——治疗组)。
两组患者的NO值及其术后变化均无统计学显著差异,传统开腹手术组(p = 0.943)和腹腔镜手术组(p = 0.393)。我们发现传统开腹手术患者术后24小时NT值升高(p = 0.000),而在腹腔镜手术组中,我们未发现NT值有统计学显著变化(传统开腹手术组(p = 0.943)和腹腔镜手术组(p = 0.393))。
在我们的研究中,我们发现传统开腹手术患者即对照组术后24小时的NT值相较于治疗组有显著升高。需要进一步进行随机研究,以更好地了解手术创伤对氧化应激反应的影响。