Effects of different trocar numbers on oxidative stress in laparoscopic cholecystectomy

INTRODUCTION: Increase in intra-abdominal pressure during pneumoperitoneum (Pp), and inflation-deflation, which cause splanchnic ischemia-reperfusion (I/R), are the reasons for oxidative stress in LS. However, not only Pp and I/R but also surgical trauma has an effect on oxidative stress. This study aims to discuss the number of trocar entry effects on oxidative stress as a surgical trauma in LS.

METHODS: Patients were divided into two groups; three-port cholecystectomy (group 1, n=20) and four-port cholecystectomy (group 2, n=20). All patients’ venous blood samples were taken three times; preoperatively, postoperative 6th and 24th hours for study Malondialdehyde (MDA) and advanced oxidation protein products (AOPP) to evaluate oxidative stress.

RESULTS: There was no statistically significant difference between the two groups. However, a statically significant difference was observed in MDA levels between preoperative and PO six hours, and duration of operation (p=0.001).

DISCUSSION AND CONCLUSION: In our study, the findings showed that laparoscopic cholecystectomy (LC) can be performed safely with three or four trocars, and a similar oxidative response was observed in both groups. Surgical trauma that arises from trocar entry (3 or 4-trocar) did not change the oxidative stress response in our patients.