The effect of CO2 insufflation-desufflation attacks on tissue oxidative stress markers during laparoscopy: a rat model.
OBJECTIVE
To determine the effects of sudden intra-abdominal pressure (IAP) changes on the terminal ileum in a pneumoperitoneum model.


METHODS
An experimental controlled study.


METHODS
University hospital in Turkey.


METHODS
Thirty-two adult female Sprague-Dawley rats.


METHODS
The rats were divided into four groups. Group 1 was not subjected to IAP. In group 2, IAP insufflation was performed continuously to keep the IAP at 10 mmHg. Groups 3 and 4 underwent an insufflation-desufflation procedure: group 3 was fluctuated 5 times, and group 4 was fluctuated 10 times within the pneumoperitoneum period of 60 minutes. Thirty minutes after the desufflation, the terminal ileum was removed for the measurement of tissue malondialdehyde (MDA) values and histopathological examination.


METHODS
The tissue MDA values and histopathological damage scores.


RESULTS
The tissue MDA values in the IAP groups (groups 2, 3, and 4) were significantly increased when compared with those of the control group. The mean MDA value in group 4 was higher than that in groups 2 and 3. Histopathologic oxidative damage scores in the mucosa and submucosal layers were significantly higher in groups 2 and 3, compared with those of the control group. However, the highest histopathologic damage scores were observed in group 4.


CONCLUSIONS
Unexpected desufflation-insufflation even at normal IAP levels during laparoscopy leads to significant oxidative stress-induced damage in the terminal ileum.
Unsal
Mesut A
MA
Department of Obstetrics and Gynecology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
Guven
Suleyman
S
Imamoglu
Mustafa
M
Aydin
Sevim
S
Alver
Ahmet
A
D000005:Abdomen / Q000601:surgery; D000818:Animals; D004487:Edema / Q000473:pathology; D005260:Female; D006470:Hemorrhage / Q000473:pathology; D007082:Ileum / Q000502:physiology / Q000503:physiopathology; D007327:Insufflation / Q000379:methods*; D007413:Intestinal Mucosa / Q000473:pathology; D010535:Laparoscopy / Q000379:methods*; D009336:Necrosis; D018384:Oxidative Stress / Q000502:physiology*; D051381:Rats; D017207:Rats, Sprague-Dawley