[Effect of enucleation of hysteromyoma by laparoscopic surgery on protein oxidation and lipid hyperoxidation].

Objective: To evaluate the effect of laparoscopic surgery on and lipid hyperoxidation in patients with hysteromyoma.

Methods: Forty patients with hysteromyoma were randomly divided into 2 equal groups: laparoscopy group and laparotomy group. The plasma advanced oxidation protein products (AOPP), malondialdehyde (MDA), antioxidant activity (AOA), and glutathione peroxidase (GPx) activity were measured before operation, just after operation (5 minutes after deflation) and 24 hours after operation.

Results: (1) In the laparoscopy group, the levels of AOPP and MDA were (50.20 +/- 9.23) micromol/L and (1.85 +/- 0.19) micromol/L before operation, increased significantly just after operation [(68.75 +/- 12.69) micromol/L and (2.52 +/- 0.55) micromol/L respectively, both P < 0.01], and recovered to the normal level 24 hour postoperatively [(49.70 +/- 9.92) micromol/L and (2.05 +/- 0.68) micromol/L respectively, both P > 0.05]. The levels of GPx and AOA decreased significantly just after operation [(0.29 +/- 0.09) U/ml vs. (0.62 +/- 0.27) U/mL and (0.90 +/- 0.24) mmol/L vs. (1.41 +/- 0.39) mmol/L respectively, both P < 0.01], and the GPx level recovered 24 hours after operation [(0.52 +/- 0.06) U/mL, P > 0.05], however, the AOA level was still lower [(1.00 +/- 0.31) mmol/L, P < 0.01]. In the laparotomy group, the levels of plasma AOPP and MDA level slightly increased just after operation in comparison with those before operation [(53.39 +/- 9.86) micromol/L vs. (52.30 +/- 7.10) micromol/L and (2.09 +/- 0.51) micromol/L vs. (1.83 +/- 0.64) micromol/L respectively, both P > 0.05] and continued to increase 24 hours after operation [(63.40 +/- 15.5) micromol/L, P < 0.05, and (2.42 +/- 0.44) micromol/L, P < 0.01]; the GPx and AOA levels decreased a little just after operation [(0.51 +/- 0.17) U/mL vs. (0.57 +/- 0.21) U/mL and (1.20 +/- 0.46) mmol/L vs. (1.33 +/- 0.37) mmol/L, both P > 0.05] and continued to decrease 24 hours after operation [(0.35 +/- 0.19) U/mL and (0.92 +/- 0.22) mmol/L respectively, both P < 0.01]. Compared with those of the laparotomy group, the plasma AOPP and MDA levels of the laparoscopy group were both significantly lower (P < 0.01 and P < 0.05), and the GPx level was significantly higher (P < 0.01) 24 hours after operation, however, the AOA level was not significantly different (P > 0.05).

Conclusion: Laparoscopic surgery is better than laparotomy. Protein oxidation and lipid hyperoxidation occur during the laparoscopic surgery, however, disappeared after operation. Free radicals are generated by the end of laparoscopic procedure, possibly as a result of an ischemia-reperfusion phenomenon induced by the inflation and deflation of the pneumoperitoneum. AOPP and MDA are induced during laparoscopic procedure and then return to the normal levels finally.