title: Peritoneal transforming growth factor beta-1 expression during laparoscopic surgery: a clinical trial.
abstract: BACKGROUND
  Transforming growth factor-beta 1 (TGF-beta1) is a growth factor involved in various biologic processes, including peritoneal wound healing and dissemination of malignancies. Laparoscopic surgery is evolving rapidly, and indications are increasing. The peritoneal TGF-beta1 expression during laparoscopic surgery is unknown.
  
  
  METHODS
  For this study, 50 patients scheduled for laparoscopic cholecystectomy were randomized into five groups, then surgically treated with various pressures, light intensities, and dissection devices. Peritoneal biopsies were taken at the beginning and end of surgery. Tissue concentrations of total and active TGF-beta1 were measured using enzyme-linked immunosorbent assay (ELISA) techniques.
  
  
  RESULTS
  There was no significant difference in either total or active TGF-beta1 concentration between peritoneal biopsies taken at the start of surgery and samples taken at the end of the procedure. Patients who underwent surgery with the ultrasonic scalpel had significant lower levels of both active (p < 0.005) and total (p < 0.01) TGF-beta1 at the end of surgery than patients treated with electrocautery. Patients who had surgery with a high light intensity had significantly lower levels of total TGF-beta1 levels (p < 0.005) with an unchanged active part than patients who had surgery with low light intensity.
  
  
  CONCLUSIONS
  The choice of dissection device and the light intensity used in laparoscopic surgery affect peritoneal TGF-beta1 concentrations, indicating that peritoneal biology can be affected by laparoscopic surgery. Because TGF-beta1 is involved in various biologic processes in the peritoneal cavity, this observation may have important clinical consequences.
authors.affiliation: Department of Surgery, Alysis Zorggroep, Locatie Rijnstate Wagnerlaan, 55 6815 AD, Arnhem, The Netherlands. w.brokelman@planet.nl
authors.forename: Walter J A
authors.initials: WJ
authors.lastname: Brokelman
authors.forename: Lena
authors.initials: L
authors.lastname: Holmdahl
authors.forename: Maria
authors.initials: M
authors.lastname: Bergström
authors.forename: Peter
authors.initials: P
authors.lastname: Falk
authors.forename: Jean H G
authors.initials: JH
authors.lastname: Klinkenbijl
authors.forename: Jean H G
authors.initials: JH
authors.lastname: Klinkonbijl
authors.forename: Michel M P J
authors.initials: MM
authors.lastname: Reijnen
authors.forename: Michael M P J
authors.initials: MM
authors.lastname: Reijnen
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000378:metabolism*; D053773:Transforming Growth Factor beta1 / Q000378:metabolism*; D014464:Ultrasonic Therapy / Q000295:instrumentation
chemical_list: D053773:Transforming Growth Factor beta1