title: Effects of carbon dioxide pneumoperitoneum on postoperative adhesion formation and oxidative stress in a rat cecal abrasion model.
abstract: BACKGROUND
  It is claimed that CO2 pneumoperitoneum (CP) is less adhesiogenic than laparotomy. Our aim in this study was to investigate the local oxidative stress responses and related adhesion formation resulting from exposure to CP.
  
  
  METHODS
  Forty-five rats were randomised into six groups. Group 1 underwent laparotomy only; in group 2, 6 mmHg CP was performed for 60 min; in group 3, the same procedure was carried out using 12 mmHg CP; in group 4, laparotomy and cecal-peritoneal abrasion were performed; in group 5, 6 mmHg CP was performed for 60 min, followed by laparotomy and cecal-peritoneal abrasion; in group 6, the same procedure was carried out using 12 mmHg CP. Groups 1, 2 and 3 were sacrificed immediately and used only for biochemical examination. The other groups were sacrificed on the 14th postoperative day.
  
  
  RESULTS
  The total adhesion scores, thickness, quantity, extent and type of adhesions decreased steadily in groups 4, 5 and 6 (p < 0.05). The median values for neutrophil and monocyte infiltration, and for capillary and fibroblast proliferation decreased steadily in groups 4, 5 and 6 (p < 0.05). CAT, SOD and GSHPx levels decreased significantly in line with increasing pressure in groups 1, 2 and 3. SOD and GSHPx levels were similar in groups 4, 5 and 6, while CAT levels decreased with increasing pressure in groups 4, 5 and 6.
  
  
  CONCLUSIONS
  It was found that CP is associated with less adhesion formation than laparotomy in the presence of similar antioxidant levels. The reduced adhesion formation is probably caused by a decreased inflammatory response.
authors.affiliation: Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Tahsin
authors.initials: T
authors.lastname: Dalgic
authors.affiliation: Department of Gastroenterological Surgery, Izmir Bozyaka Training and Research Hospital, Karabaglar, Izmir, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Oymaci
authors.affiliation: Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Erdal Birol
authors.initials: EB
authors.lastname: Bostanci
authors.affiliation: Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey. Electronic address: cakir.tebessum@gmail.com.
authors.forename: Tebessum
authors.initials: T
authors.lastname: Cakir
authors.affiliation: Department of Gastroenterological Surgery, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Kece
authors.affiliation: Deparment of Biochemistry, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Imge
authors.initials: I
authors.lastname: Erguder
authors.affiliation: Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Musa
authors.initials: M
authors.lastname: Akoglu
mesh_terms: D000818:Animals; D002245:Carbon Dioxide; D002374:Catalase / Q000378:metabolism; D002432:Cecum / Q000473:pathology / Q000601:surgery*; D049109:Cell Proliferation; D005347:Fibroblasts / Q000378:metabolism; D005979:Glutathione Peroxidase / Q000378:metabolism; D007813:Laparotomy; D009000:Monocytes / Q000378:metabolism; D009504:Neutrophils / Q000378:metabolism; D018384:Oxidative Stress; D010537:Peritoneum / Q000473:pathology / Q000601:surgery; D011028:Pneumoperitoneum, Artificial; D051381:Rats; D017207:Rats, Sprague-Dawley; D013482:Superoxide Dismutase / Q000378:metabolism; D000267:Tissue Adhesions / Q000473:pathology*
chemical_list: D002245:Carbon Dioxide; D002374:Catalase; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase
keywords: Adhesion formation; Carbon dioxide pneumoperitoneum; Oxidative stress; Pneumoperitoneum