Comparison of peritoneal oxidative stress during laparoscopy and laparotomy.
OBJECTIVE
To identify oxidative stress in peritoneum during laparoscopic and open surgery by measuring products of lipid peroxidation, and to determine whether surgical approach influences the type of oxidative metabolite synthesized.


METHODS
Retrospective analysis (Canadian Task Force classification II-2).


METHODS
University-affiliated hospital.


METHODS
Twenty-eight consecutive women with uterine myomas or ovarian cysts.


METHODS
Laparoscopic or open surgery (14 patients each).


RESULTS
We obtained 1 x 1-cm squares of peritoneum at the beginning and end of surgical procedures away from sites of surgery. 8-Isoprostaglandin F(2alpha), hydroxyeicosatetranoic acids (HETEs), and malondyaldehyde (MDA) were measured by enzyme-immunoassay, high-performance liquid chromatography, and thiobarbituric acid adduction method, respectively. Comparisons showed significant increases in 5-HETE and 8-prostane in the laparoscopy group, which were correlated with duration of pneumoperitoneum and volume of carbon dioxide (CO(2)) insufflated, respectively. In the laparotomy group only MDA rose significantly related to duration of surgery.


CONCLUSIONS
Lipid peroxidation was observed in peripheral peritoneum during laparoscopic surgery, mediated through noncyclooxygenase and lipoxygenase pathways, and appears to be due to effects of CO(2) pneumoperitoneum. Biochemical reactions were also observed in the laparotomy group, but are thought to be related to mechanisms other than lipid peroxidation.
Bentes de Souza
Angela M
AM
Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, 1/EF, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR.
Rogers
Michael Scott
MS
Wang
Chi Chiu
CC
Yuen
Pong Mo
PM
Ng
Pui Shan
PS
D000328:Adult; D002851:Chromatography, High Pressure Liquid; D015331:Cohort Studies; D015237:Dinoprost / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006893:Hydroxyeicosatetraenoic Acids / Q000032:analysis; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery; D015227:Lipid Peroxidation; D008315:Malondialdehyde / Q000032:analysis; D008875:Middle Aged; D010048:Ovarian Cysts / Q000473:pathology / Q000601:surgery; D018384:Oxidative Stress; D010537:Peritoneum / Q000737:chemistry; D011028:Pneumoperitoneum, Artificial; D011336:Probability; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery
D006893:Hydroxyeicosatetraenoic Acids; C022022:5-hydroxy-6,8,11,14-eicosatetraenoic acid; D008315:Malondialdehyde; D015237:Dinoprost