PP 25. The Role Of Pre- And Postconditioning To Avoid The Ischaemia-Reperfusion Injury Caused By Pneumoperitoneum

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G. Veres, K. Sárvári, L. Petrovics, T. Nagy, P. Hardi, I. Takács, E. Máthé, A Vereczkei, G. Jancsó

19:04 - 19:10h at Margrit Room

Categories: Gastrointestinal Surgery, Poster Session , Robotic and Minimal Invasive Surgery

Session: Poster (P2) - Gastrointestinal Surgery / Minimal Invasive

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Background
Laparoscopy is more beneficial technique in surgery than conventional open technique, but the used pneumoperitoneum has a lot ischemic side effect. Pneumoperitoneum causes oxidative stress. Aim of our investigation was to compare and evaluate the beneficial effect of pre- and postconditioning.

Material and Methods
70 Wistar rats were used. Animals were divided into 7 groups (n=10): I. group sham (only anesthesia), II. group pneumoperitoneum with 5 mmHg for 60 minutes, III. group preconditioning with 5 mmHg (5 min. insuffletion and 5 minutes desuflation), and 60 minutes pneumoperitoneum (5mmHg), IV. group pneumoteritoneum with 5 mmHg, then postconditioning (5 minutes desufflation, 5 min. insufflation and then desufflation ) , V. group pneumoperitoneum with 10 mmHg for 60 min., VI. group: preconditioning with 10 Hgmm then pneumoperitoneum for 60 min, VII. group pneumoteritoneum with 10 mmHg, then postconditioning (5 minutes desufflation, 5 min. insufflation and desufflation ). Pneumoperitoneum was created by Veres needle. Blood samples were taken 120 minutes after procedure. Oxidative stress markers: superoxide-dismutase (SOD) activity, reduced glutathione (GSH), sulfhydryl groups (SH-) and malondialdehid (MDA) concentration were measured.

Result
GSH concentration decreased, MDA activity increased, and we detected no difference in SHconcentrations in pre-and postconditioned groups comparing to control. In preconditioned 10 mmHg group there was significant elevation in SOD activity compared to 10 mmHg pneumoperitoneum. In VI.-VII groups there were significant alterations in postconditioned 10 mmHg groups compared to preconditioned ones.

Conclusion
Based on our results as short time pre- as postconditioning can reduce negative effects of pneumoperitoneum. This method has also important clinical implication.