• cardiac autonomic neuropathy
• diabetes mellitus
• heart rate variability
• intraabdominal pressure
• laparoscopic cholecystectomy

• Morbidity
• Nitrosative stress
• Oxidative stress
• Perioperative
• Reactive oxygen species
• Surgery

• 537555 National Institute of Academic Anaesthesia and British Journal of Anaesthesia/Royal College of Anaesthesia Project Grant
• 537555 National Institute of Academic Anaesthesia and British Journal of Anaesthesia/Royal College of Anaesthesia Project Grant
• 537555 National Institute of Academic Anaesthesia and British Journal of Anaesthesia/Royal College of Anaesthesia Project Grant
• 537555 National Institute of Academic Anaesthesia and British Journal of Anaesthesia/Royal College of Anaesthesia Project Grant
• 537555 National Institute of Academic Anaesthesia and British Journal of Anaesthesia/Royal College of Anaesthesia Project Grant
• 537555 National Institute of Academic Anaesthesia and British Journal of Anaesthesia/Royal College of Anaesthesia Project Grant

The aim of this study was to evaluate ovarian immunohistochemical CD95 expression in a rabbit carbon dioxide pneumoperitoneum model.

The study group including seven rabbits was subjected to intra-abdominal pressure (IAP) (12 mmHg); the control group was not subjected to IAP (the sham group, n = 7). At the end of the experiment, ovariectomy was performed. Immunohistochemical stained histologic specimen of the ovary with CD95 was evaluated. Based on the degree of cytoplasmic or membranous staining for CD95 from 0 (none) to 3 (severe), a microscopic apoptosis scoring system was used.

Statistically significantly higher apoptosis scores in ovarian surface epithelial cells (2.57 ± 0.53, vs. 1.14 ± 0.38, P = 0.002, Mann–Whitney U-test, respectively), follicular epithelial cells (2.85 ± 0.38, vs. 1.85 ± 0.38, P = 0.002, Mann–Whitney U-test, respectively), and stromal cells (2.71 ± 0.49, vs. 1.29 ± 0.49, P = 0.002, Mann–Whitney U-test, respectively) were observed in pneumoperitoneum group, compared with no-pneumoperitoneum group.

Even at safe IAP (12 mmHg) for an acceptable operation time period, there was a significant increase in apoptosis of ovarian cells.

• Apoptosis
• gynecologic endoscopy
• ovary
• pneumoperitoneum

Laparoscopic surgery (LS) is a safe and widely used technique. During LS, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences, such as elevated intra-abdominal pressure (IAP) and hypercarbia. Splanchnic and cardiovascular blood flow can be affected by the elevated IAP, which can result in ischemia in the splanchnic region prior to hemodynamic changes. Changes in gastric pH may be an early precursor of changes in splanchnic blood circulation. This study investigated the relationship between gastric pH measurement and IAP in patients undergoing LS.

This study included 49 patients aged 18–65 years with American Society of Anesthesiologists (ASA) physical status I – III who were undergoing elective laparoscopic cholecystectomy. A gastric pH tonometer probe was applied using an orogastric catheter. Simultaneously, insufflation pressure, cardiac apex beat (CAB), and mean arterial blood pressure (MAP) values were recorded. Indirect IAP was then measured through the bladder. Measurements were performed at baseline; at 15, 30, and 60 minutes after onset of insufflation (AI 15, AI 30, and AI 60, respectively); and at the end of insufflation (EI). Two pH measurements were obtained with a gastric tonometer pH probe, using an automated function of the gastric tonometer to improve measurement reliability.

IAP was significantly higher than baseline at AI 15, AI 30, AI 60, and EI (p<0.001). The pH₁ and pH₂ levels were significantly lower at AI 15 and AI 30, compared with baseline (p<0.001). There were no significant differences between pH₁ and pH₂ measurements at AI 60 and EI. Compared with baseline, CAB was significantly lower at AI 15, AI 30, AI 60, and EI (p=0.001, p<0.001, p=0.006). There were no statistically significant differences in MAP changes at any time point.

Elevated IAP caused by CO₂ insufflation during LS led to reductions of pH₁ and pH₂. There was a correlation between gastric pH measurement and IAP. Measurement of gastric pH may be useful to assess blood circulation in the splenic area during LS.

• elevated intra-abdominal pH
• gastric pH
• laparoscopic surgery

• abdominal compartment syndrome
• decompressive laparotomy
• intra-abdominal pressure

• Cholecystectomy
• laparoscopy
• minilaparotomy
• oxidative response

• Acute appendicitis
• laparoscopic appendectomy
• oxidative stress

Videothoracoscopic surgery leads to general organ hypoperfusion by reducing mean arterial pressure, systemic vascular resistance, and end-diastolic volume index. Oxidative stress occurs as a result of hypoperfusion. Evaluation of the short-term effects of videothoracoscopic sympathectomy on serum ischemia-modified albumin (IMA), malondialdehyde (MDA), and nitric oxide (NO) levels in patients with primary hyperhidrosis was aimed.

Twenty-six patients who underwent videothoracoscopic surgery were contributed in this study. Venous blood samples were obtained from these patients 1 h before and after the surgery. IMA, MDA, and NO levels were measured in serum samples by colorimetric methods. Albumin concentrations were also measured for each sample, and albumin-adjusted IMA levels were calculated.

Postoperative IMA, albumin-adjusted IMA, and MDA values were significantly higher compared to the preoperative values (P = 0.003, 0.027, 0.018, respectively). However, postoperative NO levels were lower than the preoperative values (P = 0.002). There was no significant difference between pre- and postoperative albumin concentrations, and there was no significant correlation between the parameters tested.

We can conclude that elevation in MDA and IMA levels after videothoracoscopic surgery was caused by increased oxidative stress due to minimal ischemia-reperfusion injury after the infusion of CO₂ during the surgical process. Videothoracoscopic sympathectomy operation causes a decrease in NO production, and this should be taken in consideration when evaluating nitrosative stress in videothoracoscopic surgery.

• Ischemia modified albumin
• malondialdehyde
• nitric oxide
• videothoracoscopic surgery

• Adhesion formation
• Carbon dioxide pneumoperitoneum
• Oxidative stress
• Pneumoperitoneum

• Artificial pneumoperitoneum
• Intraoperative
• Laparoscopy
• Monitoring
• Surgical instruments

• Artificial pneumoperitoneum
• Intraoperative
• Laparoscopy
• Monitoring
• Surgical instruments

• Adult
• Aged
• Bicarbonates/blood
• Blood Pressure
• Female
• Humans
• Hydrogen-Ion Concentration
• Male
• Middle Aged
• Oxygen/blood
• Pneumoperitoneum, Artificial
• Pressure
• Prospective Studies

Purpose. This study was intended to investigate the effect of dexmedetomidine on oxidative stress response in pneumoperitoneum established in rats. Methods. Animals were randomized into three groups, group S: with no pneumoperitoneum, group P: with pneumoperitoneum established, and group D: given 100 mcg intraperitoneal dexmedetomidine 30 min before establishment of pneumoperitoneum. Plasma total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) activity were measured 30 min after conclusion of pneumoperitoneum. Results. The mean TOS level was significantly higher in group P than in the other two groups, and the TOS level was significantly higher in group D than in group S (P < 0.05). Plasma TAS level was found to be lower in group P than in the other two groups, and the TAS level was lower in group D than in group S (P < 0.05). Consequently, the OSI was significantly higher in group P than in groups D and S (P < 0.05). Conclusions. Ischemia-reperfusion phenomenon that occurs during pneumoperitoneum causes oxidative stress and consumption of plasma antioxidants. Dexmedetomidine decreases oxidative stress caused by pneumoperitoneum and strengthens the antioxidant defense system.

• Dexmedetomidine
• Ischaemia–reperfusion injury
• Microscopy
• Ovary
• Pneumoperitoneum

• Adult
• Aged
• Colon/surgery
• Female
• Humans
• Laparoscopy
• Male
• Malondialdehyde/blood
• Mesentery/metabolism
• Middle Aged
• Oxidative Stress
• Oxygen/metabolism
• Pneumoperitoneum, Artificial
• Prospective Studies
• Reperfusion Injury/prevention & control
• Young Adult

• Adult
• Aged
• Chi-Square Distribution
• Cholecystectomy, Laparoscopic
• Female
• Humans
• Liver/blood supply
• Liver/physiopathology
• Liver Function Tests
• Male
• Middle Aged
• Pneumoperitoneum, Artificial/adverse effects
• Pressure
• Prospective Studies

• Adult
• Aged
• Biomarkers/blood
• Cholecystectomy, Laparoscopic/adverse effects
• Cholecystolithiasis/surgery
• Female
• Follow-Up Studies
• Glutathione/blood
• Humans
• Lipid Peroxidation/physiology
• Lipid Peroxides/blood
• Male
• Middle Aged
• Oxidative Stress
• Postoperative Complications
• Prospective Studies
• Reperfusion Injury/blood
• Risk Factors
• Spectrophotometry
• Treatment Outcome

• Animals
• Carbon Dioxide/pharmacology
• Cell Line
• Extracellular Space/metabolism
• Hydrogen-Ion Concentration
• Interleukin-6/metabolism
• Macrophages/classification
• Macrophages/drug effects
• Macrophages/metabolism
• Macrophages, Alveolar/drug effects
• Macrophages, Alveolar/metabolism
• Nitric Oxide/metabolism
• Pleura/cytology
• Protons
• Rats

AIM: To evaluate the characters, risks and benefits of laparoscopic cholecystectomy (LC) in cirrhotic portal hypertension (CPH) patients.

METHODS: Altogether 80 patients with symptomatic gallbladder disease and CPH, including 41 Child class A, 32 Child class B and 7 Child class C, were randomly divided into open cholecystectomy (OC) group (38 patients) and LC group (42 patients). The cohorts were well-matched for number, age, sex, Child classification and types of disease. Data of the two groups were collected and analyzed.

RESULTS: In LC group, LC was successfully performed in 36 cases, and 2 patients were converted to OC for difficulty in managing bleeding under laparoscope and dense adhesion of Calot’s triangle. The rate of conversion was 5.3%. The surgical duration was 62.6±15.2 min. The operative blood loss was 75.5±15.5 mL. The time to resume diet was 18.3±6.5 h. Seven postoperative complications occurred in five patients (13.2%). All patients were dismissed after an average of 4.6±2.4 d. In OC group, the operation time was 60.5±17.5 min. The operative blood loss was 112.5±23.5 mL. The time to resume diet was 44.2±10.5 h. Fifteen postoperative complications occurred in 12 patients (30.0%). All patients were dismissed after an average of 7.5±3.5 d. There was no significant difference in operation time between OC and LC group. But LC offered several advantages over OC, including fewer blood loss and lower postoperative complication rate, shorter time to resume diet and shorter length of hospitalization in patients with CPH.

CONCLUSION: Though LC for patients with CPH is difficult, it is feasible, relatively safe, and superior to OC. It is important to know the technical characters of the operation, and pay more attention to the meticulous perioperative managements.

• LC
• CPH
• OC

• Adult
• Cholecystectomy
• Cholecystectomy, Laparoscopic
• Female
• Humans
• Hypertension, Portal/etiology
• Hypertension, Portal/surgery
• Liver Cirrhosis/complications
• Liver Cirrhosis/surgery
• Male
• Middle Aged
• Treatment Outcome

N/A

• N/A