title: 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.
abstract: 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.
authors.affiliation: Department of Anesthesiology, KSU, Faculty of Medicine, Kahramanmaras, Turkey.
authors.forename: Hafize
authors.initials: H
authors.lastname: Oksuz
authors.forename: Ertan
authors.initials: E
authors.lastname: Bulbuloglu
authors.forename: Nimet
authors.initials: N
authors.lastname: Senoglu
authors.forename: Harun
authors.initials: H
authors.lastname: Ciralik
authors.forename: M Fatih
authors.initials: MF
authors.lastname: Yuzbasioglu
authors.forename: Metin
authors.initials: M
authors.lastname: Kilinc
authors.forename: Zafer
authors.initials: Z
authors.lastname: Dogan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Goksu
authors.forename: Huseyin
authors.initials: H
authors.lastname: Yildiz
authors.forename: Orhan Veli
authors.initials: OV
authors.lastname: Ozkan
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Atli
mesh_terms: 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*
chemical_list: D015032:Zinc; D010431:Pentoxifylline; D000111:Acetylcysteine