Gut oxygenation and oxidative damage during and after laparoscopic and open left-sided colon resection: a prospective, randomized, controlled clinical trial

Gianotti, Luca; Nespoli, Luca; Rocchetti, Simona; Vignali, Andrea; Nespoli, Angelo; Braga, Marco

doi:10.1007/s00464-010-1475-2

Cited by 15 publications

(12 citation statements)

References 54 publications

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“…Intestinal tissue oxygen pressure has been found to decrease significantly during mesentery traction in both laparoscopic and open colectomy. 19 The incidence of ischemia during laparoscopic procedures may be minimized by using the lowest acceptable intraabdominal pressure and by intermittent decompression and deflation during prolonged laparoscopic procedures, and by avoiding prolonged traction on the bowel during extracorporeal resection and anastomosis. Although more time is required for intracorporeal than for extracorporeal resection and anastomosis, the former may better maintain intestinal tissue oxygen pressure.…”

Section: Discussionmentioning

confidence: 99%

Colonic Necrosis Following Laparoscopic High Anterior Resection for Sigmoid Colon Cancer: Case Report and Review of the Literature

Toiyama

Hiro

Ichikawa

et al. 2017

International Surgery

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We report a patient who experienced colonic necrosis after laparoscopic high anterior resection for sigmoid colon cancer, and review the literature to evaluate the clinical features of colonic necrosis following surgery for sigmoid colon and rectal cancer. A 76year-old man with sigmoid colon cancer underwent laparoscopic high anterior resection. The operation included high ligation of the inferior mesenteric artery and end-to-end anastomosis using circular staples. Pathology findings revealed a pT4N2M0 lesion. Beginning on postoperative day (POD) 1, the patient experienced a high, spiking fever, and gradually developed leukocytosis and high inflammatory condition. The patient complained of abdominal distention, but had no signs of peritonitis. Abdominal computed tomography on POD4 showed wall thickness of the proximal colon from the anastomosis site and ascites with free air. An anastomotic leakage was suspected. Emergency laparotomy revealed a disrupted anastomosis without feces in the abdomen and a gangrenous 15 cm segment of the colon proximal to the anastomosis. The affected area of the colon was excised and Hartmann's procedure was performed. His postoperative period was uneventful. Our review of the literature demonstrates that elderly male patients with cardiovascular and pulmonary complications undergoing laparoscopic sigmoid and rectal cancer surgery with high ligation have high risk of postoperative colonic necrosis. We experienced colonic necrosis following laparoscopic high anterior resection for sigmoid colon cancer and required immediate resection. Elderly male patients with cardiovascular and pulmonary complications undergoing Int Surg 2017;102 109 laparoscopic sigmoid and rectal cancer surgery with high ligation should be carefully monitored for postoperative colonic necrosis.

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Section: Discussionmentioning

confidence: 99%

Colonic Necrosis Following Laparoscopic High Anterior Resection for Sigmoid Colon Cancer: Case Report and Review of the Literature

Toiyama

Hiro

Ichikawa

et al. 2017

International Surgery

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“…The literature data about the effect of open and laparoscopic surgery techniques on parameters of oxidative stress are unequivocal. Gianotti et al [33] demonstrated that both laparoscopy and open colon surgery may cause oxidative damage during mesentery traction and immediately after the end of operation. Bukan et al [34] showed that both open and laparoscopic cholecystectomy techniques caused an increased oxidative stress; however, laparoscopy induces less significantly oxidative stress than open surgery.…”

Section: Discussionmentioning

confidence: 99%

Effects of Open versus Laparoscopic Nephrectomy Techniques on Oxidative Stress Markers in Patients with Renal Cell Carcinoma

Mila-Kierzenkowska

Woźniak²,

Drewa³

et al. 2013

Oxidative Medicine and Cellular Longevity

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The aim of the study was to determine the concentration of lipid peroxidation products, the activity of selected antioxidant and lysosomal enzymes, and protease inhibitor in patients with renal cell carcinoma who underwent radical nephrectomy. The studied group included 44 patients: 21 of them underwent open surgery, while 23 underwent laparoscopy. Blood samples were collected three times: before treatment and 12 hours and five days after nephrectomy. In blood of participants, the concentration of thiobarbituric acid reactive substances (TBARS), the activity of catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx), and the activity of acid phosphatase (AcP), arylsulfatase (ASA), cathepsin D (CTSD), and α 1-antitrypsin (AAT) were assayed. No statistically significant differences in investigated parameters were found between studied groups. Moreover, TBARS concentration and CAT, SOD, and GPx activity were not altered in the course of both types of surgery. Five days after both open and laparoscopic nephrectomy techniques, AAT activity was higher than its activity 12 hours after the procedure. The obtained results suggest that laparoscopy may be used for nephrectomy as effectively as open surgery without creating greater oxidative stress. Reduced period of convalescence at patients treated with laparoscopy may be due to less severe response of acute-phase proteins.

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“…[21][22][23][24][25][26] Desuflation of the abdomen normalizes the IAP and splanchnic blood flow, and this may result in reperfusion resulting in a high generation of free radicals. The study 17 showed that oxygen tension compared with baseline values was only reduced when the IAP was 15 mm Hg (CO 2 ). However, these studies were primarily animal studies, case reports, or minor surgery with mostly indirect measuring techniques.…”

Section: Discussionmentioning

confidence: 98%

“…Power calculation was performed on the basis of baseline MDA from Gianotti et al 17 With a standard deviation of 0.3 mmol/L for MDA and a mean of 0.16 mmol/L with a risk of type I error of 5% and type II error of 20%, it was necessary to include 5 patients in each group. The data were tested for normal distribution with Kolmogorov-Smirnov test, and AA and DHA were normally distributed.…”

Section: Discussionmentioning

confidence: 99%

Oxidative Stress Response After Laparoscopic Versus Conventional Sigmoid Resection

Madsen

Kücükakin

Lykkesfeldt

et al. 2012

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Surgery is accompanied by a surgical stress response, which results in increased morbidity and mortality. Oxidative stress is a part of the surgical stress response. Minimally invasive laparoscopic surgery may result in reduced oxidative stress compared with open surgery. Nineteen patients scheduled for sigmoid resection were randomly allocated to open or laparoscopic sigmoid resection in a double-blind, prospective clinical trial. Three biochemical markers of oxidative stress (malondialdehyde, ascorbic acid, and dehydroascorbic acid) were measured at 6 different time points (preoperatively, 1 h, 6 h, 24 h, 48 h, and 72 h postoperatively). There were no statistical significant differences between laparoscopic and open surgery for any of the 3 oxidative stress parameters. Malondialdehyde was reduced 1 hour postoperatively (P<0.001) for all 19 patients. There was a significant drop in ascorbic acid at 1 hour and 6 hours after the first abdominal incision (P=0.002) for all 19 patients. Laparoscopic surgery was not found to be associated with reduced oxidative stress.

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Gut oxygenation and oxidative damage during and after laparoscopic and open left-sided colon resection: a prospective, randomized, controlled clinical trial

Abstract: LPS seems to be associated with a better intra- and postoperative PtiO2. High-pressure PP may impair PtiO2.

Cited by 15 publications

References 54 publications

Colonic Necrosis Following Laparoscopic High Anterior Resection for Sigmoid Colon Cancer: Case Report and Review of the Literature

Colonic Necrosis Following Laparoscopic High Anterior Resection for Sigmoid Colon Cancer: Case Report and Review of the Literature

Effects of Open versus Laparoscopic Nephrectomy Techniques on Oxidative Stress Markers in Patients with Renal Cell Carcinoma

Oxidative Stress Response After Laparoscopic Versus Conventional Sigmoid Resection

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