Re-protective effects of pre- and post-laparoscopy conditioning, zinc, pentoxifylline, and N-acetylcysteine in an animal model of laparoscopy-induced ischemia/reperfusion injury of the kidney.
BACKGROUND
Pneumoperitoneum (P) created to facilitate laparoscopy (L) is associated with splanchnic hypoperfusion, ischemia/reperfusion (I/R) injury, and oxidative stress.


OBJECTIVE
This study investigated the effects of pre- and post-laparoscopic conditioning, zinc, pentoxifylline (PTX), and N-acetylcysteine (NAC) on markers of I/R injury in an animal model.


METHODS
Sprague-Dawley male rats (n = 56, weight range 300-350 g) were randomly placed in one of seven treatment groups. Except for group C (control group who underwent a sham operation without pneumoperitoneum), pneumoperitoneum was created in all using CO(2) insufflation under a pressure of 15 mmHg. Group L (laparoscopy) was subjected to 60 min of pneumoperitoneum. Group Lpre (laparoscopic preconditioning plus laparoscopy) was subjected to 5 min of insufflation and 5 min of desufflation followed by 60 min of pneumoperitoneum. Group Lpost (laparoscopy plus laparoscopic post-conditioning) was subjected to 60 min of pneumoperitoneum and 60 min of desufflation followed by 5 min of insufflation and 5 min of desufflation. The laparoscopy plus zinc (LZ), PTX (LP), and NAC (LNAC) groups received a single intraperitoneal injection of zinc (50 mg/kg), pentoxifylline (50 mg/kg), or N-acetylcysteine (150 mg/kg) 5 min before the desufflation period. Animals were sacrificed at the end of the experiments, and kidney samples were tested for malondialdehyde (MDA), catalase (CAT), glutathione peroxidase (GPX), and superoxide dismutase (SOD).


RESULTS
MDA levels, as an indicator of oxidative stress in kidney tissue samples, were significantly higher in all pneumoperitoneum groups compared to Group C, except for Group Lpre. The pattern of change in tissue levels of SOD, GPX, and catalase was variable in the different treatment groups.


CONCLUSIONS
In this animal model of renal ischemia/reperfusion injury, laparoscopy caused renal ischemia as evidenced by elevated markers of tissue ischemia-reperfusion injury. This effect was significantly attenuated by post-laparoscopy conditioning, zinc, pentoxifylline, and N-acetylcysteine, but not by pre-laparoscopy conditioning.
Oksuz
Hafize
H
Department of Anesthesiology, KSU, Faculty of Medicine, Kahramanmaras, Turkey.
Bulbuloglu
Ertan
E
Senoglu
Nimet
N
Ciralik
Harun
H
Yuzbasioglu
M Fatih
MF
Kilinc
Metin
M
Dogan
Zafer
Z
Goksu
Mustafa
M
Yildiz
Huseyin
H
Ozkan
Orhan Veli
OV
Atli
Yalcin
Y
D000111:Acetylcysteine / Q000627:therapeutic use*; D000818:Animals; D004195:Disease Models, Animal; D007668:Kidney / Q000098:blood supply*; D010535:Laparoscopy; D008297:Male; D010431:Pentoxifylline / Q000627:therapeutic use*; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011182:Postoperative Care; D011300:Preoperative Care; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000209:etiology* / Q000517:prevention & control*; D015032:Zinc / Q000627:therapeutic use*
D015032:Zinc; D010431:Pentoxifylline; D000111:Acetylcysteine