Oxidative stress response after laparoscopic versus conventional sigmoid resection: a randomized, double-blind clinical trial.
Surgery is accompanied by a surgical stress response, which results in increased morbidity and mortality. Oxidative stress is a part of the surgical stress response. Minimally invasive laparoscopic surgery may result in reduced oxidative stress compared with open surgery. Nineteen patients scheduled for sigmoid resection were randomly allocated to open or laparoscopic sigmoid resection in a double-blind, prospective clinical trial. Three biochemical markers of oxidative stress (malondialdehyde, ascorbic acid, and dehydroascorbic acid) were measured at 6 different time points (preoperatively, 1 h, 6 h, 24 h, 48 h, and 72 h postoperatively). There were no statistical significant differences between laparoscopic and open surgery for any of the 3 oxidative stress parameters. Malondialdehyde was reduced 1 hour postoperatively (P<0.001) for all 19 patients. There was a significant drop in ascorbic acid at 1 hour and 6 hours after the first abdominal incision (P=0.002) for all 19 patients. Laparoscopic surgery was not found to be associated with reduced oxidative stress.
Department of Surgical Gastroenterology, University of Copenhagen, Herlev Hospital, Herlev, Denmark. Michael_madsen88@hotmail.com
Michael Tvilling
MT
Madsen
Bülent
B
Kücükakin
Jens
J
Lykkesfeldt
Jacob
J
Rosenberg
Ismail
I
Gögenur
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001205:Ascorbic Acid / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D012809:Colon, Sigmoid / Q000601:surgery*; D003683:Dehydroascorbic Acid / Q000378:metabolism; D043963:Diverticulosis, Colonic / Q000097:blood / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies; D012811:Sigmoid Neoplasms / Q000097:blood / Q000601:surgery*; D016896:Treatment Outcome
D015415:Biomarkers; D008315:Malondialdehyde; D001205:Ascorbic Acid; D003683:Dehydroascorbic Acid