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Preconditioning-like amelioration of erythropoietin against laparoscopy-induced oxidative injury

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Abstract

Background

Laparoscopic surgery has gained wide acceptance for almost every kind of surgical procedure, although it has produced significant oxidative injury to intraabdominal organs depending on the pressure level and the kind of the gas used. The literature describes several preventive measures for decreasing the postlaparoscopic oxidative injury such as low intraabdominal pressure, gasless laparoscopy, and laparoscopic preconditioning. Erythropoietin was shown previously to decrease ischemia–reperfusion injury to the liver. The current study evaluated the effect of erythropoietin against laparoscopy-induced oxidative injury, as compared with laparoscopic preconditioning.

Methods

For this study, 64 male Spraque–Dawley rats were randomly assigned to one of the following groups. The control group was subjected to a sham operation. The laparoscopy group was subjected to 60 min of pneumoperitoneum. The laparoscopic preconditioning plus laparoscopy group was subjected to 5 min of insufflation and 5 min of desufflation followed by 60 min of pneumoperitoneum. The erythropoietin plus laparoscopy group was subjected to a subcutaneous injection of erythropoietin as a single 1,000-U/kg dose followed by 60 min of pneumoperitoneum. After 45 min of desufflation subsequent to cessation of pneumoperitoneum, blood, liver, and kidney samples were obtained from half of the rats. The other half of the rats were observed for a reperfusion period of 24 h. Tissue and blood samples also were obtained after this period.

Results

Laparoscopy produced significant oxidative injury, as compared with the sham treatment. Laparoscopic preconditioning produced significant amelioration of the ischemic injury. Although erythropoietin administration during the prelaparoscopic period decreased the pneumoperitoneum-induced oxidative injury, the beneficial effect of laparoscopic preconditioning was more pronounced.

Conclusion

Laparoscopic preconditioning is more effective than the preischemic administration of erythropoietin in reducing laparoscopy-induced oxidative injury.

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References

  1. Altindis M, Yilmaz S, Polat C, Serteser M (2004). Sequential periods of preconditioning decrease laparoscopy-related elevations in hepatic TNF-α and IL-6 levels in rats. J Laparoendosc Adv Surg Tech 6: 380–383

    Article  Google Scholar 

  2. Ates E, Yalcin AU, Yilmaz S, Koken T, Tokyol C. Protective effect of erythropoietin on renal ischemia and reperfusion injury. ANZ J Surg (in press)

  3. Cevrioglu AS, Yilmaz S, Koken T, Tokyol C, Yilmazer M, Fenkci V (2004) Comparison of the effects of low intraabdominal pressure and ischemic preconditioning on the generation of oxidative stress markers and inflammatory cytokines during laparoscopy in rats. Hum Reprod 9: 2144–2151

    Article  Google Scholar 

  4. Colletti LM, Kunkel SL, Walz A, Burdick MD, Kunkel RG, Wilke CA, Strieter RM (1996) The role of cytokine networks in the local liver injury following hepatic ischemia–reperfusion in the rat. Hepatology 23: 506–514

    CAS  PubMed  Google Scholar 

  5. Grasso G (2001) Neuroprotective effect of recombinant human erythropoietin in experimental subarachnoid hemorrhage. J Neurosurg Sci 45: 7–14

    CAS  PubMed  Google Scholar 

  6. Kirsch AJ, Hensle TW, Chang DT, Kayton ML, Olsson CA, Sawczuk IS (1994) Renal effects of CO2 insufflation: oliguria and acute renal dysfunction in a rat model. Urology 43: 453–459

    Article  CAS  PubMed  Google Scholar 

  7. Lieber CS (1997) Role of oxidative stress and antioxidant therapy in alcoholic and nonalcoholic liver disease. Adv Pharmacol 38: 601–628

    Article  CAS  PubMed  Google Scholar 

  8. Murry CE, Jenning RB, Reimer KA (1986) Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation 74: 1124–1136

    CAS  PubMed  Google Scholar 

  9. Ohkawa H, Ohishi N, Yagi K (1979) Assay for lipid peroxidase in animal tissues by thiobarbituric acid reaction. Anal Biochem 95: 351

    Article  CAS  PubMed  Google Scholar 

  10. O’Malley C, Cunningham AJ (2001) Physiologic changes during laparoscopy. Anesthesiol Clin North Am 19: 1–19

    Article  CAS  Google Scholar 

  11. Polat C, Aktepe OC, Akbulut G, Yilmaz S, Arikan Y, Dilek ON, Gokce O (2003) The effects of increased intraabdominal pressure on bacterial translocation. Yonsei Med J 44: 259–264

    PubMed  Google Scholar 

  12. Polat C, Arikan Y, Vatansev C, Akbulut G, Yilmaz S, Dilek FH, Gokce O (2002) The effects of increased intraabdominal pressure on colonic anastomoses. Surg Endosc 16: 1314–1319

    Article  CAS  PubMed  Google Scholar 

  13. Sakanaka M, Wen TC, Matsuda S, Masuda S, Morishita E, Nagao M, Sasaki R (1998). In vivo evidence that erythropoietin protects neurons from ischemic damage. Proc Natl Acad Sci U S A 95: 635–640

    Google Scholar 

  14. Sato K, Kawamura T, Wakusawa R (2000). Hepatic blood flow and function in elderly patients undergoing laparoscopic cholecystectomy. Anesth Analg 90: 1198–1202

    Article  CAS  PubMed  Google Scholar 

  15. Schachtrupp A, Toens Ch, Hoer J, Klosterhalfen B, Lawong AG, Schumpelick V (2002) A 24-h pneumoperitoneum leads to multiple organ impairment in a porcine model. J Surg Res 106: 37–45

    Article  CAS  PubMed  Google Scholar 

  16. Schafer M, Sagesser H, Reichen J, Krahenbuhl L (2001) Alterations in hemodynamics and hepatic and splanchnic circulation during laparoscopy in rats. Surg Endosc 15: 1197–1201

    Article  CAS  PubMed  Google Scholar 

  17. Serracino-Inglott F, Habib NA, Mathie RT (2001) Hepatic ischemia–reperfusion injury. Am J Surg 181: 160–166

    Article  CAS  PubMed  Google Scholar 

  18. Siren AL, Ehrenreich H (2001) Erythropoietin: a novel concept for neuroprotection. Eur Arch Psychiatry Clin Neurosci 251: 179–184

    Article  CAS  PubMed  Google Scholar 

  19. Vittimberga FJ, Foley DP, Meyers WC, Callery MP (1998) Laparoscopic surgery and the systemic immune response. Ann Surg 227: 326–334

    Article  PubMed  Google Scholar 

  20. Walker LM, York JL, Imam SZ, Ali SF, Muldrew KL, Mayeux PR (2001) Oxidative stress and reactive oxygen species generation during renal ischemia. Toxicol Sci 63: 154–148

    Article  Google Scholar 

  21. Windberger U, Siegl H, Ferguson JG, et al (1995) Hemodynamic effects of prolonged abdominal insufflation for laparoscopic procedures. Gastrointest Endosc 41: 121–129

    CAS  PubMed  Google Scholar 

  22. Yilmaz S, Ates E, Polat C, Koken T, Tokyol C, Akbulut G, Gokce O (2003) Ischemic preconditioning decreases laparoscopy-induced oxidative stress in small intestine. Hepatogastroenterology 50: 979–982

    CAS  PubMed  Google Scholar 

  23. Yilmaz S, Ates E, Tokyol C, Pehlivan T, Erkasap S, Koken T (2004) The protective effect of erythropoietin on ischemia–reperfusion injury of liver. HPB 3: 169–173

    Google Scholar 

  24. Yilmaz S, Koken T, Tokyol C, Kahraman A, Akbulut G, Serteser M, Polat C, Gokce C, Gokce O (2003) Can preconditioning reduce laparoscopy induced tissue injury? Surg Endosc 17: 819–822

    Article  CAS  PubMed  Google Scholar 

  25. Yilmaz S, Polat C, Kahraman A, Koken T, Arikan Y, Dilek ON, Gokce O (2004) The comparison of the oxidative stress effects of different gases and intraabdominal pressures in an experimental rat model. J Laparoendosc Adv Surg Tech. 3: 165–168

    Article  Google Scholar 

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Ates, E., Yilmaz, S., Ihtiyar, E. et al. Preconditioning-like amelioration of erythropoietin against laparoscopy-induced oxidative injury. Surg Endosc 20, 815–819 (2006). https://doi.org/10.1007/s00464-005-0428-7

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  • DOI: https://doi.org/10.1007/s00464-005-0428-7

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