Increased intra-abdominal pressure during laparoscopy leads to hypoxia due to reduced blood flow. Aim of our study was to investigate whether preconditioning can reduce this negative effect of the pneumoperitoneum. Fifty female Wistar rats were used, divided into 5 groups. I: Sham operation (Sham), II: conventional pneumoperitoneum (PP), III: transvaginal pneumoperitoneum (TV), IV: preconditioning for 2.5 minutes in two cycles (Pre 2.5), V: preconditioning for 5 minutes (Pre 5). Malondialdehyde (MDA), reduced glutathione (GSH), sulfhydrylgroup (SH-) concentrations, superoxide-dismutase (SOD) and mieloperoxidase (MPO) activity, and anti-apoptotic pathway marker p-AKT level and inflammatory cytokine TNF-α were measured. SOD activity and GSH concentration were decreased in PP and TV groups comparing to Sham and preconditioning groups. MPO activity was decreased also in PP and TV groups comparing to the Sham group but in the preconditioning groups it has remained high. MDA concentration in plasma was increased in PP and TV groups comparing to Sham and preconditioning groups. There was no difference in the case of blood MDA and SH-concentrations between groups. Anti-apoptotic pathway marker p-AKT level was decreased in the TV group comparing to the sham and preconditioning groups. TNF-α level was increased in TV and preconditioning groups compared to the sham group. According to the results preconditioning can reduce negative effects of pneumoperitoneum.
1. M. Blobner R. Bogdanski E. Kochs J. Henke A. Findeis S. Jelen-Esselborn 1998 Effects of intraabdominally insufflated carbon dioxide and elevated intraabdominal pressure on splanchnic circulation: an experimental study in pigs Anesthesiology 89 475 482.
2. E. Eleftheriadis K. Kotzampassi D. Botsios E. Tzartinoglou H. Farmakis J. Dadoukis 1996 Splanchnic ischemia during laparoscopic cholecystectomy Surg Endosc 10 324 326.
3. J. Jakimowicz G. Stultiëns F. Smulders 1998 Laparoscopic insufflation of the abdomen reduces portal venous flow Surg Endosc 12 129 132.
4. C.E. Murry R.B. Jennings K.A. Reimer 1986 Preconditioning with ischemia: A delay of lethal cell injury in ischemic myocardium Circulation 74 1124 1136.
5. S. Aksöyek I. Cinel D. Avlan L. Cinel C. Oztürk P. Gürbüz A. Nayci U. Oral 2002 Intestinal ischemic preconditioning protects the intestine and reduces bacterial translocation Shock 18 476 480.
6. Z.A. Placer L.L. Cushman B.C. Johnson 1966 Estimation of product of lipid peroxidation (malonyl dialdehyde) in biochemical systems Anal Biochem 16 359 364.
7. J. Sedlak R.H. Lindsay 1968 Estimation of total protein-bound and nonprotein sulphydryl groups in tissue with Ellman's reagent Anal Biochem 25 192 205.
8. H.P. Misra I. Fridovich 1972 The role of superoxide anion in the antioxidation of epinephrine and a simple assay for superoxide dismutase J Biol Chem 247 3170 3175.
9. I. Gál E. Rôth J. Lantos G. Varga T.J. Mohamed J. Nagy 1998 A laparoscopos cholecystectomia indukálta sebészi trauma Orvosi Hetilap 139 739 746.
10. I. Gál E. Rôth J. Lantos G. Varga T.J. Mohamed 1997 Inflammatory mediators and surgical trauma regarding laparoscopic access: free radical mediated reactions Acta Chirurgica Hung 36 97 99.
11. N.C. Gutt T.C. Schmandra 1999 Portal venous flow during CO2 pneumoperitoneum in the rat Surg Endosc 13 902 905.
12. G. Akbulut C. Polat F. Aktepe S. Yilmaz A. Kahraman M. Serteser C. Gökçe O. Gökçe 2004 The oxidative effect of prolonged CO2 pneumoperitoneum on renal tissue of rats Surg Endosc 18 1384 1388.
13. H. Emir M. Akman A. Belce K. Gümüştaş Y. Söylet 2001 Is intestinal ischemia a risk of laparoscopy? An experimental study in rabbits Eur J Pediatr Surg 11 158 162.
14. C. Polat S. Yilmaz M. Serteser 2003 The effect of intra-abdominal pressures on lipid peroxidation and protein oxidation status during laparoscopic cholecystectomy Surg. Endosc. 17 1719 1722.
15. M. Pross H.U. Schulz A. Flechsig T. Manger W. Halangk W. Augustin H. Lippert T. Reinheckel 2000 Oxidative stress in lung tissue induced by CO(2) pneumoperitoneum in the rat Surg Endosc 14 1180 1184.
16. S. Yilmaz E. Ates C. Polat T. Koken C. Tokyol G. Akbulut O. Gokce 2003 Ischemic preconditioning decreases laparoscopy-induced oxidative stress in small intestine Hepatogastroenterology 50 979 982.
17. A.S. Cevrioglu S. Yilmaz T. Koken C. Tokyol M. Yilmazer I.V. Fenkci 2004 Comparison of the effects of low intra-abdominal pressure and ischaemic preconditioning on the generation of oxidative stress markers and inflammatory cytokines during laparoscopy in rats Hum Reprod 19 2144 2151.
18. S. Yilmaz T. Koken C. Tokyol A. Kahraman G. Akbulut M. Serteser C. Polat C. Gokce O. Gokce 2003 Can preconditioning reduce laparoscopy-induced tissue injury? Surg Endosc 17 819 824.
19. E. Ates S. Yilmaz E. Ihtiyar B. Yasar E. Karahuseyinoglu 2006 Preconditioning-like amelioration of erythropoietin against laparoscopyinduced oxidative injury Surg Endosc 20 815 819.
20. D.A. Sahin B. Haliloglu F.K. Sahin G. Akbulut H. Fidan G. Koken S. Buyukbas F. Aktepe Y. Arikan O.N. Dilek 2007 Stepwise rising CO2 insufflation as an ischemic preconditioning method J Laparoendosc Adv Surg Tech A. 17 723 729.
21. N.V. Solenkova V. Solodushko M.V. Cohen J.M. Downey 2006 Endogenous adenosine protects preconditioned heart during early minutes of reperfusion by activating Akt Am J Physiol Heart Circ Physiol 290 441 449.
22. T. Sammour A. Mittal B.P. Loveday A. Kahokehr A.R. Phillips J.A. Windsor A.G. Hill 2009 Systematic review of oxidative stress associated with pneumoperitoneum Br J Surg 96 836 850.