Research Paper
E-ISSN NO : 2455-295X | VOLUME : 2 | ISSUE : 10 | OCT 2016
APPRAISAL OF OXIDATIVE STRESS IN OPEN VERSUS LAPARASCOPIC CHOLECYSTECTOMY
Dr. Amrita Mukherjee 1 | Dr. Soumya Gayen 2 | Dr. Jayanta Kumar Rout 1 1
Assistant Professor, Dept. of Biochemistry, R. G. Kar Medical College, Kolkata-004, W. B., India. (*Corresponding Author)
2
MS, MCh, (Plastic Surgery), Medical College, Kolkata, W. B., India.
ABSTRACT Cholecystectomy is one of the most common surgeries in the operative world. The choice between open and laparoscopic procedures is a major point of decision taking among surgeons. This study aims to evaluate the effect of oxidative stress on these procedures and how it influences the course of these procedures. Out of 50 study subjects 25 were operated on by open and 25 by laparoscopic procedures and the total antioxidant (TAS) and thiobarbituric acid reactive substances(TBARS) were assayed preoperatively, 90 mins and 12 hours postoperatively. It was found that the level of TBARS was significantly higher in open cholecystectomy in all three temporal profile and TAS was lower in open cases. Keywords: Oxidative Stress, Total Antioxidant Status, Thiobarbituric Acid Reacting Substances, Cholecystectomy, Tbars
Introduction: Cells under aerobic condition are always threatened with the insult of ROS which however efficiently taken care by antioxidant systems of our body as 5% or more of the inhaled O2 is converted to reactive oxygen species (ROS), such as O.2, H2O2, OH. by univalent reduction of oxygen. If the generation of ROS exceeds the capacity of the antioxidant defenses the oxidative stress results. The ultimate effect of oxidative stress is the damage to all types of biomolecules including DNA, proteins and lipids. The primary target depends upon type of cells, type of stress imposed and severity of stress. In acute cholecystitis elective laparoscopic cholecystectomy is now established as the treatment of choice for symptomatic subjects (1). The oxidative stress markers are elevated in surgical procedures due to ischemia/reperfusion injury due to variation of intra-abdominal pressure on account of generation of pnemoperitoneum (2). Immediately after cholecystectomy they will rise to a certain extent and hours after post operative period a further rise can be noticed. But an increased rate of rise of such markers can be early predictors of complications where inflammatory tissue injury remains in action. However in post operative period of open cholecystectomy these indicators are more elevated than laparoscopic cholecystectomy indicating the choice of surgery also.
Materials and methods: The objectives of the study are to assess the variation of values of the indicator after cholecystectomy, to assess the role of these parameters as early predictor of post operative complications, to prevent the possibilities of oxidative tissue damage in the process of operative management of cholecystitis in future. Patients were selected from Surgical Out Patient Department (OPD) of N.R.S. Medical College and Hospital. A comparative study was undertaken in the department of Surgery in collaboration with Department of Biochemistry, N. R. S. Medical College & Hospital, Kolkata, West Bengal. The study was conducted in patients of chronic calculous cholecystitis. Patients selected for the study were those who were symptomatic for last 6 months, with no history of jaundice, USG showed GB stone with normal CBD diameter and absence of calculi in CBD, LFT reports were within normal limits. Patients excluded from the study were those having stone in biliary tree other than gall bladder, having acute inflammatory symptoms, having empyema, mucocele or carcinoma of gall bladder. 50 subjects of chronic calculus cholecystitis were selected after a through screening by maintaining our inclusion criteria. These subjects were than randomly planned for open and laparoscopic cholecystectomy having 25 subjects in each group. Outcome of the study was compared between the two groups.
Parameters studied: 1) Outcomes of the two different modes of surgical procedures will be studied biochemically after 90 minutes and 12 hours in comparison to preoperative values. 2) Sonological and biochemical parameters to include and exclude patients were performed as discussed above.
INTERNATIONAL EDUCATIONAL SCIENTIFIC RESEARCH JOURNAL
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