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Human Reproduction, Vol. 18, No. 10, 2181-2188, October 2003
© 2003 European Society of Human Reproduction and Embryology

The effect of intra-abdominal pressure on the generation of 8-iso prostaglandin F2{alpha} during laparoscopy in rabbits

Ângela M.Bentes de Souza, Chi Chiu Wang, Ching Yan Chu, Po Mui Lam and Michael Scott Rogers1

Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR

1 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, 1/EF Prince of Wales Hospital, Shatin–New Territories, Hong Kong SAR. e-mail: msrogers{at}cuhk.edu.hk

BACKGROUND: Carbon dioxide pneumoperitoneum induces peritoneal oxidative stress. The aim of this study was to verify the effect of intra-abdominal pressure on oxidative stress in the peritoneum and on post-operative adhesion formation. METHODS: Forty-one rabbits underwent laparoscopic surgery: either gasless, or with CO2-pneumoperitoneum at pressures of 5, 10 or 15 mmHg. Serial parietal peritoneal biopsies were taken at various time-points: immediately after reaching the abdominal cavity, 30, 60, 90 and 120 min afterwards, and 15 min after abdominal desufflation. 8-iso prostaglandin F2{alpha} (8-iso PGF2{alpha}), a marker of oxidative stresss, was assayed by enzyme immunoassay and adhesion formation was scored by second-look laparoscopy on day 14. RESULTS: The gasless group showed no significant changes in 8-iso PGF2{alpha}. Conversely, significant changes occurred in CO2-pneumoperitoneum in a time- and pressure-dependent manner. Adhesions developed only in the CO2-pneumoperitoneum groups, and total adhesion score was correlated with the amount of CO2 insufflated and intra-abdominal pressure, but not with 8-iso PGF2{alpha}, which was correlated with intra-abdominal pressure. CONCLUSION: Intra-abdominal pressure increased 8-iso PGF2{alpha} in the parietal peritoneum in a graded fashion, whilst gasless laparoscopy had no impact. It also influenced the frequency and severity of adhesion formation, but no causal link was found between 8-iso PGF2{alpha} and post-operative adhesion formation.

Key words: adhesion formation/intra-abdominal pressure/ischaemia/isoprostanes/laparoscopy


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