Białecki Jacek T, Myszka Waldemar, Wysocka Ewa, Sowier Sebastian, Pyda Przemysław, Antkowiak Ryszard, Antkowiak Łukasz, Sowier Anna, Krasiński Zbigniew
Department of General Surgery, Franciszek Raszeja Memorial Hospital, Poznan, Poland.
Department of Clinical Biochemistry and Laboratory Medicine, Chair of Chemistry and Clinical Biochemistry, Poznan University of Medical Sciences, Poznan, Poland.
Wideochir Inne Tech Maloinwazyjne. 2020 Dec;15(4):567-573. doi: 10.5114/wiitm.2020.93202. Epub 2020 Feb 24.
Surgical treatment is always associated with tissue damage and the subsequent development of oxidative stress.
To compare the oxidative stress response in patients treated operatively for inguinal hernia with multi-trocar laparoscopic totally extraperitoneal technique (TEP) or single-incision laparoscopic totally extraperitoneal technique (TEP-SI).
A randomized group of 34 patients with one-sided inguinal hernia was enrolled in the study. Seventeen patients were treated with a standard TEP method (group 1) and the other 17 patients were treated with the TEP-SI technique (group 2). Thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAS) as the oxidative stress markers were measured before surgery (0), 1 day (1) and 4 days (2) after surgery.
A decrease in TAS on the first day after surgery was observed in both groups. Sustained reduction on the fourth day after surgery was observed in group 1, whereas in group 2 an increase followed. A statistically significant difference was observed in TAS (2 : 0) ratio with a meaningful decrease in group 1. TBARS concentration was elevated 1 day after surgery in both groups. It remained at an elevated level on the fourth day after surgery in group 1, while it decreased in group 2. The duration of surgery was higher in group 2 (mean: 57.5 min) than in group 1 (mean: 50.0 min) (p = 0.0286).
Oxidative stress levels are lower in patients treated operatively by TEP-SI technique than by TEP. TEP-SI may be considered as a less invasive technique associated with less tissue injury.
手术治疗总是伴随着组织损伤以及随后氧化应激的发生。
比较采用多通道腹腔镜完全腹膜外技术（TEP）或单切口腹腔镜完全腹膜外技术（TEP-SI）手术治疗腹股沟疝患者的氧化应激反应。
随机选取34例单侧腹股沟疝患者纳入本研究。17例患者采用标准TEP方法治疗（第1组），另外17例患者采用TEP-SI技术治疗（第2组）。在手术前（0）、手术后1天（1）和手术后4天（2）测量作为氧化应激标志物的硫代巴比妥酸反应性物质（TBARS）和总抗氧化状态（TAS）。
两组患者术后第1天TAS均下降。第1组术后第4天持续下降，而第2组随后上升。观察到TAS（2:0）比值有统计学意义的差异，第1组有显著下降。两组患者术后1天TBARS浓度均升高。第1组术后第4天仍处于升高水平，而第2组则下降。第2组手术时间（平均：57.5分钟）高于第1组（平均：50.0分钟）（p = 0.0286）。
采用TEP-SI技术手术治疗的患者氧化应激水平低于采用TEP治疗的患者。TEP-SI可被认为是一种侵入性较小、组织损伤较小的技术。
