Effects of Heated Pneumoperitoneum on Inflammation, Oxidative Stress, and Peritoneal Histology in Female Dogs That Underwent Video-Assisted Ovariohysterectomy.

Marco A M Silva,Daniel C De M Müller,Sumanta Nandi,Vanessa Z Sarturi,Gabriela P Coradini,Bernardo N Antunes,Vanessa Milech,Cínthia M De Andrade,Marcella T Linhares,Thaís R Mann,Juliana S De Oliveira,Michelli A W De Ataide,Maurício V Brun,Hellen F Hartmann,Glaucia D Kommers

doi:10.1155/2021/5515559

Abstract

Laparoscopic procedures require the creation of pneumoperitoneum. CO2, which must be cold and dry, is the standard gas used in such surgeries. The type of gas used, its temperature, and moisture may change the peritoneal surface and cause systemic and local oxidative stress. Our objective is to evaluate the influence of pneumoperitoneum heating on the occurrence of histological lesions in the peritoneum, inflammation, plasma oxidative stress, and on the mesothelial surface in patients undergoing video-assisted ovariohysterectomy. Twenty canine females were included and distributed evenly into two groups: heated CO2 (HG) and unheated CO2 (UHG). The biomarkers of inflammation and oxidative stress were evaluated before insufflation (T0), at 30 min (T1), and at 60 min (T2) of exposure to CO2. Biopsies of the peritoneal tissue for histological evaluation were performed at T0 and T2. Regarding plasma parameters, acetylcholinesterase (AChE) showed a greater activity in the HG at T1 (p=0.0268) and T2 (p=0.0423); in turn, butyrylcholinesterase (BChE) showed a greater activity at T2 in the HG (p=0.0175) compared with T0. Catalase activity (CAT) was different between HG times; it was higher at T1 (p=0.0253). There was a decrease in the levels of substances reactive to thiobarbituric acid (TBARS) (p=0.0117) and in glutathione (GSH) (p=0.0114) between T0 and T2 in the UHG. Regarding tissue oxidative stress, the CAT in the HG showed a greater activity at T2 than T1 (p=0.0150). By comparing the groups at each time, there was a difference only at T2 (p=0.0288), being greater in the HG. Regarding the activity of superoxide dismutase (SOD) in the HG, there was a difference between T2 in relation to T0 and T1 (p=0.0181); finally, there was an increase only at T1 (p=0.0287) in the UHG when comparing groups at the same time. There were no differences in the histological parameters evaluated. Our study demonstrates that the heating of CO2 generates a greater inflammatory response and forms reactive oxygen species (ROS) at the plasma and peritoneal levels.

Highlights

Laparoscopic surgery induces less tissue trauma because of smaller surgical incisions and minimal tissue dissections, meticulous hemostasis, use of microsurgical instruments, and a smaller operative field [1, 2]. Such surgeries require the creation of pneumoperitoneum, which is obtained through peritoneal insufflation using dry carbon dioxide (CO2) (0.5% relative moisture) at 20–25°C, currently considered the gas choice for laparoscopy [3, 4]
E animals were randomly assigned into two groups: the first group was submitted to pneumoperitoneum with unheated CO2 (UHG) at room temperature, and the second group was submitted to pneumoperitoneum with heated CO2 (HG) at 37°C
In view of the results, we believe that the increased activity of AChE and BChE is related to exposure to heated and dry gas, indicating an increase in the inflammatory response of heated gas (HG) compared with unheated gas (UHG). e findings of the present study suggest that the generation of inflammation in the HG is related to the fact that low temperatures have a reducing effect on tissue metabolism [36]

Summary

Research Article

Effects of Heated Pneumoperitoneum on Inflammation, Oxidative Stress, and Peritoneal Histology in Female Dogs That Underwent Video-Assisted Ovariohysterectomy. Our objective is to evaluate the influence of pneumoperitoneum heating on the occurrence of histological lesions in the peritoneum, inflammation, plasma oxidative stress, and on the mesothelial surface in patients undergoing video-assisted ovariohysterectomy. The CAT in the HG showed a greater activity at T2 than T1 (p 0.0150). By comparing the groups at each time, there was a difference only at T2 (p 0.0288), being greater in the HG. Regarding the activity of superoxide dismutase (SOD) in the HG, there was a difference between T2 in relation to T0 and T1 (p 0.0181); there was an increase only at T1 (p 0.0287) in the UHG when comparing groups at the same time. Our study demonstrates that the heating of CO2 generates a greater inflammatory response and forms reactive oxygen species (ROS) at the plasma and peritoneal levels

Introduction

Materials and Methods

Time periods

Findings

Inflammatory cells