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腹腔镜手术中的二氧化碳气腹是否会干扰腹部手术伤口的胶原蛋白沉积?

Does CO2 pneumoperitoneum in laparoscopy interfere with collagen deposition in abdominal surgical wounds?

作者信息

Morais Pedro Henrique Alves de, Silva Rafael Francisco Alves, Ribeiro Thiago da Silva, Farias Igor Eduardo Caetano de, Lino Junior Ruy de Souza, Carneiro Fabiana Pirani, Durães Leonardo de Castro, Sousa João Batista de

机构信息

Universidade de Brasília, Brazil.

Medical School, Centro Universitário de Brasília, Brazil.

出版信息

Acta Cir Bras. 2020;35(6):e202000605. doi: 10.1590/s0102-865020200060000005. Epub 2020 Jul 13.

Abstract

Purpose To determine by histomorphometric analysis whether CO2 pneumoperitoneum interferes with collagen deposition in surgical wounds in the aponeurosis of rats. Methods This experiment involved 80 male Wistar rats, randomly allocated into four groups according to pneumoperitoneum period (PRE: 30 min preoperatively; POST: 30 min postoperatively; PP: 30 min pre- and postoperatively; C: control group). CO2 pneumoperitoneum was insufflated to 5 mmHg of pressure. A laparotomy was performed; 1 cm of the left colon was then resected, and an end-to-end anastomosis was performed to simulate surgical trauma, after which the abdominal wall was closed. On postoperative days 7 or 14, a sample of the abdominal wall was collected, stained with picrosirius red and observed under polarized light in an optical microscope. The amount of collagen was estimated by computerized histomorphometric analysis. Results There were no significant differences in collagen deposition between the control and experimental groups on postoperative days 7 (p=0.720) or 14 (p=0.933). The amount of collagen increased as expected in all groups between postoperative days 7 and 14 (p=0.0003). Conclusion At 5 mmHg, CO2 pneumoperitoneum does not interfere with collagen deposition in abdominal wall surgical wounds in rats.

摘要

目的 通过组织形态计量学分析确定二氧化碳气腹是否会干扰大鼠腱膜手术伤口中的胶原蛋白沉积。方法 本实验涉及80只雄性Wistar大鼠,根据气腹时间随机分为四组(PRE:术前30分钟;POST:术后30分钟;PP:术前和术后各30分钟;C:对照组)。将二氧化碳气腹压力充至5 mmHg。进行剖腹手术;然后切除1 cm的左结肠,并进行端端吻合以模拟手术创伤,之后关闭腹壁。在术后第7天或第14天,采集腹壁样本,用苦味酸天狼星红染色,并在光学显微镜下偏振光下观察。通过计算机组织形态计量学分析估计胶原蛋白的含量。结果 在术后第7天(p = 0.720)或第14天(p = 0.933),对照组和实验组之间的胶原蛋白沉积没有显著差异。在术后第7天至第14天,所有组中的胶原蛋白含量均如预期增加(p = 0.0003)。结论 在5 mmHg时,二氧化碳气腹不会干扰大鼠腹壁手术伤口中的胶原蛋白沉积。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a273/7357835/a261799749ed/1678-2674-acb-35-6-e202000605-gf01.jpg

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