The effect of CO2 pneumoperitoneum on serum prostate-specific antigen levels in patients undergoing laparoscopic cholecystectomy.

Background: Recently, several studies have shown an elevation of serum prostate-specific antigen (PSA) levels after the events associated with presumed pelvic ischemia. Although it has been shown that CO2 pneumoperitoneum during laparoscopic surgery causes splanchnic ischemia, no study has investigated the PSA levels after this procedure. This study aimed to evaluate the effects of CO2 pneumoperitoneum on serum total PSA (tPSA) and free PSA (fPSA) levels in patients undergoing laparoscopic cholecystectomy.

Methods: This study involved 30 men who underwent elective laparoscopic cholecystectomy. Serum tPSA and fPSA levels and f/tPSA ratios were determined the day before surgery (baseline), immediately before insufflation, after desufflation, and 24 hours and 7 days after surgery.

Results: Serum tPSA and fPSA values after desufflation and 24 hours after surgery were significantly higher than the values before insufflation and at baseline (P<0.01), whereas the f/tPSA ratio did not change (P>0.05). PSA levels decreased to baseline levels after 7 days.

Conclusions: Our study showed that CO2 pneumoperitoneum during laparoscopic surgery can cause a rise in serum tPSA and fPSA levels. We think that CO2 pneumoperitoneum during laparoscopic surgery should be added to list of the events in which PSA measurements must be interpreted with caution.