Research The Variation Of CTGF Value In Human Serum Between Laparotomy Surgery And Laparoscopic Surgery

ObjectiveThe formation and serious degree of postoperative adhesions relate to the operative trauma. CTGF(connective tissue growth factory),as an important fibrotic cell factory, plays an important role in the formation of postoperative abdominal adhesion. By detecting the serum of patients and normal females with CTGF values, we probe into the influence of different operative way to the formation and serious degree of postoperative adhesion.MethodWe detected the CTGF serum values of patients who experienced laparotomy and laparoscopic surgery through ELISA(enzyme linked immunosorbent assay). We compared the preoperative CTGF serum values by SNK method among laparotomy group, laparoscopic group and normal control group. We compared the preoperative and the postoperative CTGF serum value in each experimental group by matched T testing method. We compared the postoperative CTGF serum value between laparotomy group and the laparoscopic group by T testing method.Result1. The laparotomy group, including the enucleation of uterus myoma (12 examples), ovarian cyst or mesosalpinx cyst (8 examples), subtotal or total hysterectomy (2&13 examples), contains 35 examples. Its preoperative CTGF serum value is 121.22±35.95ng/L. The laparoscopic group, including enucleation of uterus myoma (10 examples), ovarian cyst or mesosalpinx cyst (10 examples), subtotal or total hysterectomy (14&1 examples), contains 35 examples. Its preoperative CTGF serum value is 115.87±24.90ng/L. The normal control group contains 20 examples. Its CTGF serum value is 110.77±20.35ng/L. Compared by the SNK method, the three P values all exceed 0.05(q1:2/P1=0.201, q1:3/P2=0.531, q2:3/P3=0.442). It illustrates that there is no significant difference between the laparotomy preoperative group, the laparoscopic preoperative group and the normal control group. Meanwhile, it is also consistent with the information in the literature that there is low expression of CTGF serum value in the normal status or under the situation that has eliminated fibrosis of tissues and organs.2. There is a significantly statistical difference(t=4.419, P＜0.05) between the preoperative and postoperative CTGF serum values in the laparotomy enucleation group(123.47±37.78ng/L,202.78±97.65ng/L), including enucleation of uterus myoma, ovarian cyst or mesosalpinx cyst, by using T testing method. There is a significantly statistical difference(t=7.491, P<0.05) between the preoperative and postoperative CTGF serum values in the laparotomy subtotal or total hysterectomy group(118.21±34.43ng/L,432.10±176.15ng/L) by using T testing method. There is a significantly statistical difference(t=3.484, P＜0.05) between the preoperative and postoperative CTGF serum values in the laparoscopic enucleation group(109.97±18.66ng/L,204.86±126.20ng/L), including enucleation of uterus myoma, ovarian cyst or mesosalpinx cyst, by using T testing method. There is a significantly statistical difference(t=5.339, P<0.05) between the preoperative and postoperative CTGF serum values in the laparoscopic subtotal or total hysterectomy group(123.75±30.27ng/L,302.41±127.14ng/L) by using T testing method.3. There is a no significantly statistical difference(t=0.058, P=0.954>0.05) with the postoperative CTGF serum values between the laparotomy enucleation group and the laparoscopic enucleation group(202.78±97.65ng/L,204.86±126.20ng/L) by using T testing method. There is a significantly statistical difference(t=2.312, P=0.028<0.05) with the postoperative CTGF serum values between the laparotomy group and the laparoscopic group of subtotal or total hysterectomy(432.10±176.15ng/L, 302.41±127.14ng/L) by using T testing method.Conclusion1. We compared any experimental groups and found that there was a significantly statistical difference between preoperative and postoperative CTGF serum values. Both laparotomy surgery or laparoscopic surgery were able to cause the postoperative adhension.2. Comparing the postoperative CTGF serum values between the laparotomy group or the laparoscopic group during the enucleation of uterus myoma, ovarian cyst or mesosalpinx cyst, we found that there was no significantly statistical difference. Comparing the postoperative CTGF serum values between the laparotomy group or the laparoscopic group during the subtotal or total hysterectomy, we found that there was a significantly statistical difference. It prompts that there is no difference in the postoperative adhesion between laparotomy and laparoscopic surgery when the operation is relatively easy and the operation time is relatively short. However, when the operation is relatively complex and the operation time is relatively long, the formational probability of postoperative adhesion after the laparoscopic surgery is smaller than that after the laparotomy surgery, while the serious degree of postoperative adhesion in laparoscopic surgery is lighter than that in laparotomic surgery.