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| 2. |
- Brokelman, Walter J A, et al.
(författare)
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Peritoneal transforming growth factor beta-1 expression during laparoscopic surgery: a clinical trial.
- 2007
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Ingår i: Surgical endoscopy. - : Springer Science and Business Media LLC. - 1432-2218 .- 0930-2794. ; 21:9, s. 1537-41
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Transforming growth factor-beta 1 (TGF-beta1) is a growth factor involved in various biologic processes, including peritoneal wound healing and dissemination of malignancies. Laparoscopic surgery is evolving rapidly, and indications are increasing. The peritoneal TGF-beta1 expression during laparoscopic surgery is unknown. METHODS: For this study, 50 patients scheduled for laparoscopic cholecystectomy were randomized into five groups, then surgically treated with various pressures, light intensities, and dissection devices. Peritoneal biopsies were taken at the beginning and end of surgery. Tissue concentrations of total and active TGF-beta1 were measured using enzyme-linked immunosorbent assay (ELISA) techniques. RESULTS: There was no significant difference in either total or active TGF-beta1 concentration between peritoneal biopsies taken at the start of surgery and samples taken at the end of the procedure. Patients who underwent surgery with the ultrasonic scalpel had significant lower levels of both active (p < 0.005) and total (p < 0.01) TGF-beta1 at the end of surgery than patients treated with electrocautery. Patients who had surgery with a high light intensity had significantly lower levels of total TGF-beta1 levels (p < 0.005) with an unchanged active part than patients who had surgery with low light intensity. CONCLUSION: The choice of dissection device and the light intensity used in laparoscopic surgery affect peritoneal TGF-beta1 concentrations, indicating that peritoneal biology can be affected by laparoscopic surgery. Because TGF-beta1 is involved in various biologic processes in the peritoneal cavity, this observation may have important clinical consequences.
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| 3. |
- Lensvelt, Mare M A, et al.
(författare)
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Decreased Peritoneal Expression of Active Transforming Growth Factor {beta}1 During Laparoscopic Cholecystectomy With Heated Carbon Dioxide.
- 2010
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Ingår i: Archives of surgery (Chicago, Ill. : 1960). - : American Medical Association (AMA). - 1538-3644 .- 0004-0010. ; 145:10, s. 968-72
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Laparoscopic surgery involves the establishment of a pneumoperitoneum, mostly using carbon dioxide. Cooling of the peritoneum, due to insufflation, may traumatize the peritoneum and disturb local biological processes. The current study was performed to assess the effect of the temperature of carbon dioxide on peritoneal transforming growth factor β1 (TGF-β1) expression. DESIGN: Patients were randomized into 2 groups. In one group, a pneumoperitoneum was created with carbon dioxide at room temperature; in the other, with carbon dioxide at body temperature. Peritoneal biopsy specimens were taken at the start and end of surgery. SETTING: Community hospital. PATIENTS: Thirty patients scheduled for laparoscopic cholecystectomy. MAIN OUTCOME MEASURES: Tissue concentrations of total and active TGF-β1 were measured using enzyme-linked immunosorbent assays. RESULTS: At the start of surgery, there were no significant differences between groups in the total and active fractions of TGF-β1. At the end of the procedure, the peritoneal active TGF-β1 concentrations were significantly lower (P=.03) in patients receiving carbon dioxide at body temperature. In contrast, the concentrations of total TGF-β1 did not differ between groups. A slight, nonsignificant increase in total and active TGF-β1 levels was observed in patients receiving unheated carbon dioxide. The ratio of active to total TGF-β1 did not change during procedures, and there were no differences between groups. CONCLUSIONS: Heating of carbon dioxide, used for insufflation, to body temperature decreases the expression of active TGF-β1 in the peritoneum. Considering the broad biological effects of TGF-β1, including the regulation of peritoneal healing and oncological processes, this observation might have clinical repercussions.
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| 4. |
- Lensvelt, Mare M A, et al.
(författare)
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Peritoneal transforming growth factor beta-1 expression during prolonged laparoscopic procedures.
- 2010
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Ingår i: Journal of laparoendoscopic & advanced surgical techniques. Part A. - : Mary Ann Liebert Inc. - 1557-9034 .- 1092-6429. ; 20:6, s. 545-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Laparoscopic surgery may affect peritoneal physiology. Short-term laparoscopic surgery does not affect peritoneal transforming growth factor beta (TGF-b1) expression. The current study was conducted to evaluate the hypothesis that prolonged laparoscopic surgery may affect peritoneal TGF-b1 expression. STUDY DESIGN: In the first study, 24 patients scheduled for a right colonic resection were enrolled in the trial. Twelve underwent conventional surgery (CCR) and 12 were operated on laparoscopically (LCR). In the second study, 12 patients undergoing laparoscopic gastric bypass (LGB) surgery for morbid obesity were included. Biopsies of the parietal peritoneum were taken at standardized moments during the procedures. Tissue concentrations of active and total TGF-b1 were measured by using enzyme-linked immunosorbent assays. RESULTS: During the LCR, there was a significant increase in peritoneal active TGF-b1 levels (P < 0.05). A similar, but not significant, trend was observed during the CCR. A similar pattern was seen in the total TGF-b1 concentrations during both procedures. The LGB procedure did not affect peritoneal active or total TGF-b1 concentrations. During the procedure, both the active and total TGF-b1 levels were significantly higher in the LCR, when compared to the LGB, group (P < 0.05). CONCLUSIONS: Prolonged laparoscopic surgery may affect peritoneal TGF-b1 expression, depending on the procedure performed. Considering the role of TGF-b1 in various biologic processes, including adhesiogenesis and oncology, these results may have clinical consequences.
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| 5. |
- Brokelman, Walter J A, et al.
(författare)
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Decreased peritoneal tissue plasminogen activator during prolonged laparoscopic surgery.
- 2009
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Ingår i: The Journal of surgical research. - : Elsevier BV. - 1095-8673 .- 0022-4804. ; 151:1, s. 89-93
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Peritoneal fibrinolysis is crucial in the peritoneal healing processes and subsequent adhesion formation. During conventional surgery, the peritoneal fibrinolytic system is rapidly disturbed. Short-term laparoscopy does not seem to affect peritoneal fibrinolysis. The aim of the present study was to assess the effect of prolonged laparoscopic surgery on peritoneal fibrinolysis. METHODS: Twelve consecutive patients undergoing laparoscopic gastric bypass surgery for morbid obesity were included in the study. During the procedure, biopsies of the parietal peritoneum were taken at the start of the procedure and each 45 min afterward. Tissue samples were homogenized and tissue-type plasminogen activator (tPA) antigen, tPA activity, urokinase-type PA antigen, and plasminogen activating inhibitors type 1 antigen were measured using commercial assay techniques. RESULTS: Both tPA antigen and its activity progressively decreased during the procedure, reaching significant levels after 90 min of surgery. The levels of uPA antigen and plasminogen activating inhibitors antigen did not significantly change throughout the procedure. CONCLUSIONS: As for conventional surgery, prolonged laparoscopic surgery causes a decreased fibrinolytic activity in the peritoneum due to decreased tPA levels.
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| 6. |
- Brokelman, Walter J A, et al.
(författare)
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Peritoneal fibrinolytic response to various aspects of laparoscopic surgery: a randomized trial.
- 2006
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Ingår i: The Journal of surgical research. - : Elsevier BV. - 0022-4804. ; 136:2, s. 309-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Peritoneal fibrinolysis is important in peritoneal wound healing processes and adhesion formation. The peritoneal fibrinolytic response to laparoscopy is merely unknown. In the present study we investigate the effect of short-term laparoscopy on the peritoneal fibrinolytic response and the influence of intra-abdominal pressure, light intensity and choice of dissection device on this response. METHODS: There were 50 patients scheduled for laparoscopic cholecystectomy randomized in five groups operated with various pressures, light intensities, and dissection devices. Peritoneal biopsies were taken at the beginning and the end of the procedure. Tissue concentrations of tissue-type plasminogen activator (tPA), urokinase-type plasminogen activator (uPA), plasminogen activator inhibitor type 1 (PAI-1), and the tPA-activity were measured using ELISA techniques. RESULTS: There were no differences in tPA antigen, tPA-activity, uPA antigen, or PAI-1 antigen concentrations in biopsies taken at the beginning compared to samples taken at the end of the operation. Different intra-abdominal pressures, light intensities and the choice dissection device did not affect any of the measured parameters. CONCLUSION: Short-term laparoscopy does not affect the peritoneal fibrinolytic activity. The used intra-abdominal pressure, light intensity and choice of dissection device do not affect peritoneal activity during short-term laparoscopy.
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