[Comparative study of the impacts of laparoscopic and open laparotomic surgeries on oxidative stress in patients with uterine myomas]

OBJECTIVE: To evaluate the impact of laparoscopic surgery on oxidative stress in patients with uterine myomas. METHODS: Plasma malondialdehyde (MDA), antioxidant activity (AOA), and glutathione peroxidase (GPx) activity in 20 patients with uterine myomas were measured before, at the end of (5 min after deflation), and 24 h after laparoscopic surgery, for comparison with the measurements in 20 patients receiving laparotomic surgery at the same time points. RESULTS: Immediately following laparoscopic surgery, plasma MDA level increased significantly as compared with the preoperative level (P<0.01) and recovered the normal level 24 h after the operation; but in laparotomic surgery, plasma MDA level underwent a slight increase in the immediately early postoperative stage and continued to increase 24 h after the operation. In laparoscopic surgery, GPx and AOA decreased significantly in the early postoperative stage (P<0.01) and recovered to some extent 24 h postoperatively, whereas in laparotomic surgery, GPx and AOA slightly decreased immediately following the operation and further decreased 24 h after the operation. Compared with patients receiving laparotomic surgery, laparoscopic patients had significantly lower plasma MDA level (P<0.01) and significantly higher GPx activity (P<0.01) with comparable AOA level (P=0.33) 24 h after the operation. CONCLUSION: Free radical produces at the end of a laparoscopic procedure, possibly as a result of ischemia-reperfusion induced by the inflation and deflation of the pneumoperitoneum.