Effect Of Carbon Dioxide Insufflation During Retroperitoneal Laparoscopic Surgery On Morphology & IL-6 & TNF-α Of Perirenal Fat

Objective To investigate the influence of carbon dioxide insufflation during retroperitoneal laparoscopic surgery on morphology of perirenal fat. By the research of changed of content with carbon dioxide insufflation of retroperitoneal laparoscopic operation and open operation on perirenal fat IL-6 & TNF-α, to appraise the effect of organization's immune function with carbon dioxide insufflation of posterior laparoscopic operation on organism.Methods To select twenty-five patients with disease of adrenal, disease of kidney, disease of epimere of ureter excluding active chronic inflammation. They were divided into 2 groups randomly to undergo retroperitoneal laparoscopic surgery with carbon dioxide aerate(n=13) or open operation (n=12) respectively. Specimens of perirenal fat were obtained at different time points, 0 min, 30 min, 60 min, 90min and120 min after the beginning of observation, i. e. e, insufflation or opening of the peritoneal cavity, the morphological changes of adipose cells observed using light microscope ( LM)and transmission electron microscopy (TEM). Determine the content of IL-6 & TNF-α. And comparing the different influence of ultramicrostructure and IL-6 and TNF-α,at different operation, in different time.Results In the open surgery group, there was no marked change of distance of adipose cells, cytolemma,cellorgan, caryon, during 0min,30min,60min and 90 min after the beginning of observation.However, in the carbon dioxide insufflation during retroperitoneal laparoscopic surger group bulging up of cytolemma and bioblast was evident immediately at the time of filling of carbon dioxide, cytolemma breakage and Intercellular spaces widen and bulging up of bioblast obviously and cytolysosome and phagocyte could be found 30 min later, 60 min later bioblast was broken,caryotin was change,caryon was not integrity.and 90 min apoptosis was found. Content of perirenal fat's IL-6 of steps up after the intervention of carbon dioxide insufflation, compared with 90 min, 120 min steps down greatly, but nonsense in statistic. TNF-αdegrades in less range after the intervention of carbon dioxide insufflation, compared with 120 min, 90 min steps up greatly, but nonsense in statistic. The changing difference between two groups has nonsense in statistic. Compared with carbon dioxide insufflation of laparoscopic operation group (retroperitoneal laparoscopic surgery group), content of perirenal fat IL-6 of open operation group (Open group) has no obvious difference in 0 min, but has marked difference in 30 min, 60 min, 90 min (P < 0. 05). Content of fat organization TNF-αhas no obvious difference between the two groups in 0min, 30min, but has marked difference in 60min, 90min (P < 0. 05).Conclusion There is significant changes of morph of perirenal fat and level of IL-6 & TNF-αbetween two groups, which correlate with duration of insufflation positively .The changes may have an effect on function of organism.