title: Cardiac and Liver Marker Alterations After Laparoscopic Gynaecologic Operations.
abstract: OBJECTIVE
  In our study, we aimed to investigate the effect of laparoscopic procedures in which the abdominal cavity at a Trendelenburg position of 15 degrees was insufflated with CO2 on cardiac and liver markers.
  
  
  METHODS
  Forty patients scheduled for laparoscopic gynaecological surgery were included in the study. Venous blood samples were taken the day before operation and 6 hours after surgery, and later, lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase-MB (CK-MB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), myoglobin (MY) and d-dimer (d-D) were measured.
  
  
  RESULTS
  There was no statistically significant difference in the values of preoperative and postoperative ALT (16.8±9.4 and 17.8±9.3; p=0.579), AST (19.4±7 and 20.9±7.6; p=0.361) and ALP (65.2±16.2 and 63.3±16.9; p=0.609), but LDH (385.1±117.3 and 460.6±156.3; p=0.003), CK (113.8±138.5 and 247.9±283.5; p=0.0001), CK-MB (22.8±13.3 and 28.7±16; p=0.011), MY (28.1±12.9 and 138.8±129; p=0.0001) and d-D (509.5±815: 1026±1054; p=0.0001) increased significantly.
  
  
  CONCLUSIONS
  After laparoscopic operations in the Trendelenburg position, postoperative serum ALT, AST and ALP levels, remained unchanged, when compared to preoperative values, but LDH, CK, CK-MB, myoglobin and d-dimer values increased significantly.
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Nadir Sıtkı
authors.initials: NS
authors.lastname: Şinikoğlu
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Gümüş
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Nalan
authors.initials: N
authors.lastname: Şanlı
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Totoz
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ayşin
authors.initials: A
authors.lastname: Alagöl
authors.affiliation: Department of Biostatistics, Trakya University Faculty of Medicine, Edirne, Turkey.
authors.forename: Nesrin
authors.initials: N
authors.lastname: Turan
keywords: Gynaecological laparoscopic surgery; Trendelenburg; cardiac enzymes; liver enzymes