Advances in Clinical and Experimental Medicine
2014, vol. 23, nr 6, November-December, p. 885–892
Publication type: original article
The Effects of Different Intraabdominal Pressure Protocols in Laparoscopic Procedures on Oxidative Stress Markers and Morphology in Rat Ovaries
1 Fatsa Gynecology and Maternity Training and Research Hospital of TC Ministry of Health, Ordu, Turkey
2 Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
3 Department of Histology and Embryology, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
4 Department of Biochemistry, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
Background. To determine the effects of different intraabdominal pressure (IAP) on the ovaries in a laparoscopic rat model.
Objectives. The aim of the study was to determine the effects on the ovaries of different intraabdominal pressures (IAP) in laparoscopic surgery in a rat model.
Material and Methods. Thirty-two post-pubertal nonpregnant Sprague-Dawley rats were divided randomly into four groups. In the control group, no intraabdominal pressure (IAP) was applied. In Group Pp10 and Group Pp15, an IAP of 10 and 15 mm Hg, respectively, were applied by carbon dioxide insufflation for 60 min, and a 30-min desufflation was carried out. In Group IPp15, a 15 mm Hg IAP was applied for 10 min, and then CO2 was desufflated for 10 min. After this ischemic preconditioning, IAP was established at 15 mm Hg for 60 min, after which CO2 was desufflated for 30 min. Erythrocyte and ovarian tissue malondialdehyde (MDA) and histopathologic damage scores were evaluated.
Results. In Groups Pp10 and Pp15, ovarian tissue MDA values were significantly increased compared to the control group. In Groups Pp10 and Pp15, erythrocyte MDA values were significantly increased when compared to Group IPp15 and the control group. Ovarian histopatological assesment scores were significantly higher in Group Pp15 than in Groups Pp10 and IPp15.
Conclusion. Pneumoperitoneum causes injuries to abdominal organ such as the ovaries. The ischemic preconditioning method is more effective in reducing oxidative stress due to laparoscopic pneumoperitoneum than lowpressure pneumoperitoneum methods.
ischemic preconditioning, pneumoperitoneum, oxidative stress, reperfusion, laparoscopy.
- Al-Fozan H and Tulandi T: Safety and risks of laparoscopy in pregnancy. Curr Opin Obstet Gynecol 2002, 14, 375–379.
- Sharma KC, Kabinoff G, Ducheine Y, Tierney J, Brandstetter RD: Laparoscopic surgery and its potential for medical complications. Heart Lung 1997, 26, 52–64.
- Sutton C: A practical approach to surgical laparoscopy. In: Endoscopic surgery for gynecologists. Eds.: Sutton C, Daimond M, W.B. Saunders, Philadelphia 1998, 2nd ed., 41–53.
- Goitein D, Papasavas P, Yeaney W, Gagne D, Hayetian F, Caushaj P: Microsphere intestinal blood flow analysis during pnömoperitonyum using carbon dioxide and helium. Surg Endosc 2005, 19, 541–545.
- Chiu AW, Chang LS, Birkett DH and Babayan RK: The impact of pnömoperitonyum and gassles laparoscopy on systemic and renal hemodynamics. J Am Coll Surg 1995, 181, 397–406.
- Eleftheriadis E and Kotzampasi K: Influence of pnömoperitonyum on the mesenteric circulation. In Rosenthal RJ, Friedman RL, and Philips EH (eds) The pathophysiology of pnömoperitonyum. Springer, New York, USA, 1998, 49–61.
- O’Malley C and Cunningham AJ: Physiologic changes during laparoscopy. Anesthesiol Clin North Am 2001, 19, 1–19.
- Richter S, Olinger A, Hildebrandt U, Menger MD and Vollmar B: Loss of physiologic hepatic blood flow control (‘hepatic arterial buffer response’) during CO2 pnömoperitonyum in the rat. Anesth Analg 2001, 93, 872–877.
- Neudecker J, Sauerland S, Neugebauer E, Bargamaschi R, Bonjer HJ, Cuschieri A: European Association for Endoscopic Surgery clinical practice guideline on the pnömoperitonyum for laparoscopic surgery. Surg Endosc 2002, 16, 1121–1143.
- Schäfer M, Krähenbühl L: Effects of laparoscopy on intra-abdominal blood flow. Surgery 2001, 129, 385–389.
- Bentes de Souza AM, Wang CC, Chu CY: The effect of intra-abdominal pressure on the generation of 8-iso prostaglandin F2α during laparoscopy in rabbits. Hum Reprod 2003, 18, 2181–2188.
- Kaya Y, Coşkun T, Demir MA: Abdominal insufflation-deflation injury in small intestine in rabbits. Eur J Surg 2002, 168, 410–417.
- Polat C, Yilmaz S, Serteser M: The effect of different intra-abdominal pressures on lipid peroxidation and protein oxidation status during laparoscopic cholecystectomy. Surg Endose 2003, 17, 1719–1722.
- Li C and Jackson RM: Reactive species mechanisms of cellular hypoxia-reoxygenation injury. Am J Physiol Cell 2002, 282, 227–241.
- Ates E, Yilmaz S, Ihtiyar E: Preconditioning-like amelioration of erythropoietin against laparoscopy-induced oxidative injury. Surg Endosc 2006, 20, 815–819.
- Sozmen EY, Tanyalçın T, Kutay F: Ethanol induced oxidative stress and membrane injury in rats. Eur J Clin Chem Clin Biochem 1994, 32, 741–744.
- Sheehan DC, Hrapchak BB: Theory and Practice of Histotechnology. Battelle Memorial Institute, Ohio 1987.
- Schachtrupp A, Toens C, Hoer J, Klosterhalfen B, Lawong AG, Schumpelick V: A 24-h pnömoperitonyum leads to multiple organ impairment in a porcine model. J Surg Res 2002, 106, 37–45.
- Abu-Rafea B, Vilos GA, Vilosa AG: Effect of body habitus and parity insufflated CO2 volume at various intraabdominal pressures during laparoscopic Access in women. JMIG 2006, 13, 205–210.
- Madl C, Druml W: Gastrointestinal disorders of the critically ill. Systemic consequences of ileus. Best Pract Res Clin Gastroenterol 2003, 17, 445–456.
- Sies H: Oxidative stress: Oxidants and antioxidants. Exp Physiol 1997, 182, 291–295.
- Eleftheriadis E, Kotzampassi K, Papanotas K, Heliadis N and Sarris K: Gut ischaemia, oxidative stress and bacterial translocation in elevated abdominal pressure in rats. World J Surg 1996, 20, 11–16.
- Serracino-Inglott F, Habib NA, Mathie RT: Hepatic ischaemia-reperfusion injury. Am J Surg 2001, 181, 160–166.
- Lieber CS: Role of oxidative stres and antioxidant therapy in alcoholic and nonalcoholic liver diseases. Adv Pharmacol 1997, 38, 601–628.
- Yilmaz S, Polat C, Kahraman A, Koken T, Arikan Y, Dilek ON, Gokce O: The comparison of the oxidative stress effects of different gases and intra-abdominal pressures in an experimental rat model. J Laparoendos Adv Surg Techn 2004, 14, 165–168.
- Giraudo G, Brachet CR, Cacceta M, Morino M: Gasless laparoscopy could avoid alterations in hepatic function. Surg Endosc 2001, 15, 741–746.
- Guven S, Muci E, Unsal MA: The effects of carbon dioxide pneumoperitoneum on ovarian blood flow, oxidative stres markers, and morphology during laparoscopy: a rabbit model. Fertil Steril 2010, 93, 1327–1332.
- Imamoglu M, Cay A, Unsal MA: The effects of increased intraabdominal pressure on testicular blood flow, oxidative stres markers, and morphology. J Pediatr Surg 2006, 41, 1118–1124.
- Murry CE, Jenning RB, Reimer KA: Preconditioning with ischaemia: a delay of lethal cell injury in ischemic myocardium. Circulation 1986, 74, 1124–1136.
- Sola A, Hotter G, Prats N, Xaus C, Gelpi E, Rosello-Catafau J: Modification of oxidative stress in response to intestinal preconditioning. Transplantation 2000, 69, 767– 772.
- Gonj JP, Tu B, Wang W, Peng Y, Li SB, Yan LN: Protective effect of nitric oxide induced by ischemic preconditioning on reperfusion injury of rat liver graft. World J Gastroenterol 2004, 10, 73–76.
- Unsal MA, Imamoglu M, Kadioglu M: The acute alterations in biochemistry, morphology, and contractility of rat-isolated terminal ileum via increased intra-abdominal pressure. Pharmacol Res 2006, 53, 135–141.
- Cevrioglu AS, Yilmaz S, Koken T: Comparison of the effects of low intraabdominal pressure and ischaemic preconditioning on the generation of oxidative stres markers and inflammatory cytokines during laparoscopy in rats. Hum Reprod 2004, 19, 2144–2151.