title: Electrocautery causes more ischemic peritoneal tissue damage than ultrasonic dissection.
abstract: BACKGROUND
  Minimizing peritoneal tissue injury during abdominal surgery has the benefit of reducing postoperative inflammatory response, pain, and adhesion formation. Ultrasonic dissection seems to reduce tissue damage. This study aimed to compare electrocautery and ultrasonic dissection in terms of peritoneal tissue ischemia measured by microdialysis.
  
  
  METHODS
  In this study, 18 Wistar rats underwent a median laparotomy and had a peritoneal microdialysis catheter implanted in the left lateral sidewall. The animals were randomly assigned to receive two standard peritoneal incisions parallel to the catheter by either ultrasonic dissection or electrocautery. After the operation, samples of microdialysis dialysate were taken every 2 h until 72 h postoperatively for measurements of pyruvate, lactate, glucose, and glycerol, and ratios were calculated.
  
  
  RESULTS
  The mean lactate-pyruvate ratio (LPR), lactate-glucose ratio (LGR), and glycerol concentration were significantly higher in the electrocautery group than in the ultrasonic dissection group until respectively 34, 48, and 48 h after surgery. The mean areas under the curve (AUC) of LPR, LGR, and glycerol concentration also were higher in the electrocautery group than in the ultrasonic dissection group (4,387 vs. 1,639, P=0.011; 59 vs. 21, P=0.008; 7,438 vs. 4,169, P=0.008, respectively).
  
  
  CONCLUSIONS
  Electrosurgery causes more ischemic peritoneal tissue damage than ultrasonic dissection.
authors.affiliation: Department of Surgery, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Richard P G
authors.initials: RP
authors.lastname: ten Broek
authors.forename: Joyce
authors.initials: J
authors.lastname: Wilbers
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
mesh_terms: D000818:Animals; D019540:Area Under Curve; D004210:Dissection / Q000379:methods*; D004564:Electrocoagulation / Q000009:adverse effects*; D005947:Glucose / Q000032:analysis; D007511:Ischemia / Q000209:etiology / Q000378:metabolism; D007773:Lactates / Q000032:analysis; D008297:Male; D017551:Microdialysis; D010537:Peritoneum / Q000098:blood supply / Q000293:injuries*; D011773:Pyruvates / Q000032:analysis; D051381:Rats; D017208:Rats, Wistar; D014464:Ultrasonic Therapy / Q000379:methods*
chemical_list: D007773:Lactates; D011773:Pyruvates; D005947:Glucose