Prevention of pulmonary complications of pneumoperitoneum in rats

Abstract

Background: Carbon dioxide (CO2) pneumoperitoneum facilitates the visualization of abdominal organs during laparoscopic surgery. However, the associated increase in intra-abdominal pressure causes oxidative stress, which contributes to tissue injury.

Objective: We investigated the ability of the antioxidant and anti-inflammatory drug Erdosteine to prevent CO2 pneumoperitoneum-induced oxidative stress and inflammatory reactions in a rat model.

Methods: Fourteen female adult Wistar albino rats were divided into a control group (Group A, n = 7) and an Erdosteine group (Group B, n = 7). Group A received 0.5 cc/day 0.9% NaCl, and Group B received 10 mg/kg/day Erdosteine was administered by gavage, and maintained for 7 days prior to the operation. During the surgical procedure, the rats were exposed to CO2 pneumoperitoneum with an intra-abdominal pressure of 15 mmHg for 30 min. The peritoneal gas was then desufflated. The rats were sacrificed following 3 h of insufflation. Their lungs were removed, histologically evaluated, and scored for intra-alveolar hemorrhage, alveolar edema, congestion, and leukocyte infiltration. The results were statistically analyzed. A value of P < 0.05 was considered statistically significant.

Results: Significant differences were detected in intra-alveolar hemorrhage (P < 0.05), congestion (P < 0.001), and leukocyte infiltration (P < 0.001) in Group A compared with Group B. However, the differences in alveolar edema were not statistically significant (P = 0.698).

Conclusions: CO2 pneumoperitoneum results in oxidative injury to lung tissue, and administration of Erdosteine reduces the severity of pathological changes. Therefore, Erdosteine may be a useful preventive and therapeutic agent for CO2 pneumoperitoneum-induced oxidative stress in laparoscopic surgery.

Figure 1

Photomicrograph of histopathology from Group A (Control) displaying increased intra-alveolar hemorrhage (thin short arrow), congestion (thick short arrow), and leukocyte infiltration (thick long arrow). Alveolar edema (double arrow) was slight. (Hematoxylin-Eosin, original magnification × 20)

Figure 2

Photomicrograph of histopathology from Group B (Erdosteine) displaying decreased intra-alveolar hemorrhage (thin short arrow), congestion (thick short arrow), and leukocyte infiltration (thick long arrow). Alveolar edema (double arrow) was slight. (Hematoxylin-Eosin, original magnification × 20)