Preconditioning-like amelioration of erythropoietin against laparoscopy-induced oxidative injury.
BACKGROUND
Laparoscopic surgery has gained wide acceptance for almost every kind of surgical procedure, although it has produced significant oxidative injury to intraabdominal organs depending on the pressure level and the kind of the gas used. The literature describes several preventive measures for decreasing the postlaparoscopic oxidative injury such as low intraabdominal pressure, gasless laparoscopy, and laparoscopic preconditioning. Erythropoietin was shown previously to decrease ischemia-reperfusion injury to the liver. The current study evaluated the effect of erythropoietin against laparoscopy-induced oxidative injury, as compared with laparoscopic preconditioning.


METHODS
For this study, 64 male Spraque-Dawley rats were randomly assigned to one of the following groups. The control group was subjected to a sham operation. The laparoscopy group was subjected to 60 min of pneumoperitoneum. The laparoscopic preconditioning plus laparoscopy group was subjected to 5 min of insufflation and 5 min of desufflation followed by 60 min of pneumoperitoneum. The erythropoietin plus laparoscopy group was subjected to a subcutaneous injection of erythropoietin as a single 1,000-U/kg dose followed by 60 min of pneumoperitoneum. After 45 min of desufflation subsequent to cessation of pneumoperitoneum, blood, liver, and kidney samples were obtained from half of the rats. The other half of the rats were observed for a reperfusion period of 24 h. Tissue and blood samples also were obtained after this period.


RESULTS
Laparoscopy produced significant oxidative injury, as compared with the sham treatment. Laparoscopic preconditioning produced significant amelioration of the ischemic injury. Although erythropoietin administration during the prelaparoscopic period decreased the pneumoperitoneum-induced oxidative injury, the beneficial effect of laparoscopic preconditioning was more pronounced.


CONCLUSIONS
Laparoscopic preconditioning is more effective than the preischemic administration of erythropoietin in reducing laparoscopy-induced oxidative injury.
Ates
E
E
General Surgery Department, Osmangazi University, The Faculty of Medicine, Eskisehir, Turkey.
Yilmaz
S
S
Ihtiyar
E
E
Yasar
B
B
Karahuseyinoglu
E
E
D000818:Animals; D004921:Erythropoietin / Q000008:administration & dosage / Q000494:pharmacology*; D007279:Injections, Subcutaneous; D007327:Insufflation / Q000592:standards; D007770:L-Lactate Dehydrogenase / Q000097:blood; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D018384:Oxidative Stress / Q000187:drug effects; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000209:etiology* / Q000517:prevention & control*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D014409:Tumor Necrosis Factor-alpha; D004921:Erythropoietin; D008315:Malondialdehyde; D007770:L-Lactate Dehydrogenase