Original scientific paper
Tissue Ischemia Due to CO2 Pressure during Laparoscopic Radical Prostatectomy
Nado Vodopija
; Department of Urology, General Hospital, Slovenj Gradec, Slovenia
Zdenka Ovčak
; Institute of Pathology, University Clinical Centre, Ljubljana, Slovenia
Marko Zupančić
; Department of Urology, General Hospital, Slovenj Gradec, Slovenia
Ljubo Koršič
; Department of Urology, General Hospital, Slovenj Gradec, Slovenia
Franc Kramer
; Department of Urology, General Hospital, Slovenj Gradec, Slovenia
Zoran Krstanoski
; Department of Urology, General Hospital, Slovenj Gradec, Slovenia
Ivan Parać
; Department of Urology, General Hospital, Slovenj Gradec, Slovenia
Abstract
Laparoscopic radical prostatectomy is nowadays one of the most frequently performed urological surgical procedures. For insufflation in laparoscopic radical prostatectomy (LRP) CO2 is used, with the pressure in the operative region between 12 and 15 mm Hg. At the microcirculation level, the pressure is lower, which raises the possibility of ischemic tissue damage during the procedure. The activity of glutathione peroxidase (GSH-px), superoxide dismutase (SOD) and catalase (CAT) was measured at the beginning and immediately after the end of the surgery in 44 patients who underwent LRP and in 11 who underwent retropubic radical prostatectomy (RRP). Capillary endothelial damage was assessed by applying immunohistochemical and morphometric methods to tissue samples from the urinary bladder neck, which contains all layers of the bladder wall. Measurement of the enzyme activity showed no significant increase of GSH-px (p-0.431), SOD (p-0.220) and CAT (p-0.434) levels. Neither immunohistochemical analysis of the bladder neck capillaries with i-nitric oxide synthase (i-NOS) nor morphometric analysis showed signs of endothelial ischemic damage.
Keywords
prostatic carcinoma; CO2 pressure; tissue ischemia; free radicals; glutathione peroxidase; superoxide dismutase; catalase
Hrčak ID:
39534
URI
Publication date:
1.3.2009.
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