Effects Of Different Pneumoperitoneal Pressure On Cell Factors In Gynecological Laparosc Opic Surgery

Objectivewith the development of laparoscopic surgery, laparoscopic surgery has been widely accepted, but Basic medical field on the corresponding research also vigorously, Especially in immunology。This study was designed to explore the effect of laparoscopic surgery on the host immune response in patients with benign gynecologic disorders required to operation. Cytokine (interleukin-6,interleukin-1 and tumor necrosis factor-a)levels in serum correlate with extent of tissue trauma and inflammatory reaction. By assaying the above parameters during operative periodwe evaluated differences in the systemic immune response after gynecological laparoscopy with different pneumoperitoneal pressure. Based on above findings,We try to provide further evidences for the smaller damage induced by the laparoscopicprocedures. According to the above research, We are looking forward to Find more suitable to bring the minimum damage of pneumoperitoneal pressure.MethodsData of sixty patients with benign gynecologic disorders required to surgery were collected from October 2008 to June 2009 of second hospital of the china medical university.The patientes with acute inflammation,stress response,vital organs disorders and previous use of immune inhibitor were not included. Data of groups were similar in terms of range of operation,age,size of bump in the three groups.The general conditions of patients were recorded routinely,referring to volume of blood loss,lasting time of operation,para-operative complications,postoperative peak of body temperature and recovered time of gastroenteric function,days of hospital stay,as well as total inpatient expense.Blood samples were taken at preoperatively, midoperatively and 12h postoperati-vely, respectively. Serum concentrations of IL-1,IL-6 and TNF-αwere measured with enzyme-linked immunosorbent assay(ELISA)。All the data mentioned above were analyzed with SPSS 13.0 statistical software. Results were shown with mean±S, applied with analysis of multi-mean variance (ANOVA)within onegroup,Contrast between groups with Student's t-test.There was significant difference on statistics if the value of P was less than 0.05.Results1. Levels of IL-6 IL-1 and TNF-αin serum of High, medium and low gasless laparoscopic surgery of pressure groups:in the three groups:concentration of all the three indexindex of intraoperatie was significantly higher than index of Preoperative, and index of postoperative was higher than index of Preoperative, index of postoperative was lower than index of intraoperatie.2. Levels of IL-6 IL-1 and TNF-ain serum of High, medium and low gasless laparoscopic surgery of pressure groups:each index of Preoperative:High, medium and low gasless laparoscopic surgery of pressure groups have no statistical difference(P>0.05).3. Each index of intraoperatie:index of the high gasless pressure was higher than index of the midle gasless pressure; index of the midle gasless pressure was higher than index of the low gasless pressure.(P<0.01)4. Each index of postoperative:each index of Preoperative:High, medium and low gasless laparoscopic surgery of pressure groups have no statistical difference (P>0.05).ConclusionsInfluence of different pneumoperitoneal pressure on patients'immune system. in gynecological laparoscopy:High, medium and low gasless laparoscopic surgery of pressure groups all Restrain the immune function. But, for the pressure groups of gasless inhibition degree below high pressure groups, including low measured pressure groups of gasless minimum.