| Objective:Through analysis of laparoscopic and abdominal hysterectomy preoperative and postoperative serum markers of endothelial cell injury endothelin - 1 (ET-1) changes, and in vitro in human umbilical vein endothelial cell line ECV304 observed in both cases changes in cell morphology were determined at different time points the concentration of ET-1 change to carbon dioxide pneumoperitoneum laparoscopic surgery to explore other factors on endothelial cell function by the surgeon the possibility of influence, for laparoscopic surgery whether caused by endothelial cell damage, to prevent deep vein thrombosis to provide a theoretical basis.Method:Collected in January 2009– April 2009 in our hospital for gynecological laparoscopic and abdominal hysterectomy in patients with serum before and after surgery, two groups were the 19 cases, no significant difference in age, body weight, no medical merger disease and thrombosis risk factors, chest radiograph, blood and urine routine, liver and kidney function was normal. Preoperative bleeding did not use drugs and anticoagulants, the cases generally balanced line test, such as: body mass index, uterine size, and pelvic adhesions and so on. And with the informed consent of patients.Pre-experiment: The double-antibody sandwich enzyme-linked immunoassay (ELISA) to determine the initial eight patients testing inactivated, not inactivated serum endothelin - 1 level; determine the samples were not inactivated serum as the source.1. Selection of laparoscopic hysterectomy in 19 cases, the same period total abdominal hysterectomy in 19 cases, respectively, before surgery, after anesthesia and surgery at the end of venous blood, serum endothelin - 1 (ET-1 ) levels were observed in the carbon dioxide pneumoperitoneum laparoscopic surgery and abdominal surgery on ET-1.2. Select the laparoscopic hysterectomy and abdominal hysterectomy in patients with the 8 cases, their serum before and after surgery as a medium, the role of the ECV304 cell line in vitro, the morphological changes and by enzyme-linked double-antibody sandwich immunological method (ELISA) method for different time points in the cytosol of endothelin - 1 (ET-1) content.All study data were presented as mean±standard deviation (xˉ±s) that the measurement data using paired samples t test, independent sample t test, ANOVA, multiple sample mean variance analysis (F test). The results were statistically analyzed using SPSS17.0 package.Results:1. The same patients before and after surgery is not inactivated serum and inactivated serum endothelin - 1 levels, the difference was not statistically significant (P> 0.05).2. Laparoscopic group and open group their preoperative and postoperative comparison showed: The postoperative serum endothelin - 1 (ET-1) were increased to varying degrees, but little change, the difference was not statistically significant (P > 0.05).3. Without serum blank control group, ECV304 cells cultured for 2, 6, 12, 24 hours later, the cell culture medium concentration of ET-1 change was no significant difference (P> 0.05).4. Laparoscopic group and open group, preoperative and postoperative serum after adding ECV304 cell culture medium, cultured for 2, 6, 12, 24 hours, the supernatants of ET-1 levels than before the intervention based on serum ET-1 concentration was increased, but no significant change (P> 0.05). Training 2h, 6h, the cells ET-1 levels in supernatant were significantly increased but not statistically significant (p> 0.05). When cultured 12h, ET-1 level changed little. 24h culture, the cell supernatant ET - 1 level decreased significantly, but no statistical significance (P> 0.05). Interventions at different times among the three groups showed no significant difference.5. Laparoscopic group, the role of surgery in ECV304 cells in serum 2, 6, 12, 24 hours after the same time, in the two groups of cell culture supernatant of ET-1 level, the difference was not significant (P> 0.05).6. Laparoscopy group of patients the serum effect on ECV304 cells 2, 6, 12, 24 hours later, after the same duration of action compared two groups of cells cultured in serum interfere with ET-1 content in the supernatant, the difference was not statistically significant ( P> 0.05).7. ECV304 cells after passage were spindle or polygonal, cobblestone mosaic arrangement of clear cell borders, abundant cytoplasm, nucleus oval center, prominent nucleoli, with vascular endothelial cell morphology. The serum for 24 hours, observed under the inverted phase contrast microscope, laparoscopic group and open group were rounded cells, cell gap increases, adherence is not strong and back off.Conclusion:1. Not inactivated serum may represent inactivated serum as the source of the test specimen, simplify the experimental procedure.2. And abdominal hysterectomy compared with laparoscopic hysterectomy does not promote the production of endothelin -1.3. Laparoscopic and abdominal hysterectomy performed,the recipients not to increase serum on cultured endothelial cell synthesis of endothelia-1 and endothelia-1 content in the length of time has nothing to do with the role.4. Laparoscopic and abdominal hysterectomy in patients with preoperative and postoperative serum role in ECV304 cells in vitro after 24 hours, cell shape changes, endothelial cell damage, indicating the existence of serum factors that damage endothelial cells.
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