Key result
Laparoscopic sigmoid resection did not significantly reduce oxidative stress compared with open surgery, although malondialdehyde was reduced at 1 hour postoperatively across all 19 patients (P<0.001).
Why the study?
Does laparoscopic sigmoid resection reduce oxidative stress compared to open surgery in patients scheduled for sigmoid resection?
RCT (n=19)
Double-blind
Randomly allocated
Does laparoscopic sigmoid resection reduce oxidative stress compared to open surgery in patients scheduled for sigmoid resection?
Laparoscopic sigmoid resection does not appear to reduce oxidative stress compared to open surgery.
Laparoscopic sigmoid resection offers no oxidative stress advantage over open surgery; challenges assumptions of reduced surgical stress with minimally invasive techniques.
Surgery is accompanied by a surgical stress response, which results in increased morbidity and mortality. Oxidative stress is a part of the surgical stress response. Minimally invasive laparoscopic surgery may result in reduced oxidative stress compared with open surgery. Nineteen patients scheduled for sigmoid resection were randomly allocated to open or laparoscopic sigmoid resection in a double-blind, prospective clinical trial. Three biochemical markers of oxidative stress (malondialdehyde, ascorbic acid, and dehydroascorbic acid) were measured at 6 different time points (preoperatively, 1 h, 6 h, 24 h, 48 h, and 72 h postoperatively). There were no statistical significant differences between laparoscopic and open surgery for any of the 3 oxidative stress parameters. Malondialdehyde was reduced 1 hour postoperatively (P<0.001) for all 19 patients. There was a significant drop in ascorbic acid at 1 hour and 6 hours after the first abdominal incision (P=0.002) for all 19 patients. Laparoscopic surgery was not found to be associated with reduced oxidative stress.
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Madsen et al. (2012) conducted an RCT in Scheduled for sigmoid resection (n=19). Laparoscopic sigmoid resection vs. Open sigmoid resection was evaluated on Biochemical markers of oxidative stress (malondialdehyde, ascorbic acid, and dehydroascorbic acid). Laparoscopic sigmoid resection did not significantly reduce oxidative stress compared with open surgery, although malondialdehyde was reduced at 1 hour postoperatively across all 19 patients (P<0.001).
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