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Study of the role of carbon dioxide as a contact gas of abdominal organs during laparoscopy versus atmospheric air during open surgery in the postoperative inflammatory response of the liver (Master thesis)

Σβορώνος, Χρήστος/ Svoronos, Christos

Aim of the study: The aim of this study was to assess the effect of CO2 versus atmospheric air on the postoperative inflammatory response in the liver parenchyma, comparing the tissue expression in the liver parenchyma of three biomarkers, IL-6, TNFα and NFκB. Materials and Methods: 66 male rats were used, which were divided into three groups. In the first group (n=6) no intervention was made (Control group). In the second group (n=30) a median laparotomy was performed under CO2 conditions at a pressure of 1 atm (CO2 group) and in the third group (n=30) in atmospheric air conditions at a pressure of 1 atm (Air group). At various time intervals postoperative (1h, 3h, 6h, 24h, 48h) liver was assessed for the expression of IL-6, TNF-α and NFκB. The immunohistochemical assessment was semiquantitative and scored from 1 to 5 based on the intensity and extent of staining. Results: Regarding NFkB, it was overexpressed in the liver parenchyma of the Air group (1h, 3h) and the level of its tissue expression was higher in the Air group than in the CO2 group at 1h and 3h postoperative. TNF-α was overexpressed in the liver parenchyma of the Air group (1h, 3h, 6h, 24h, 48h) and the CO2 group (1h, 3h, 24h, 48h), while the level of its tissue expression of NFκB was higher in the Air group than in the CO2 group at 3h, 6h, 24h and 48h postoperative. Finally, IL-6 was overexpressed in the liver parenchyma of the Air group (24h), while no differences were observed between the Air group and the CO2 group. Conclusions: The contact of the liver with CO2, a gas used in laparoscopic surgical procedures, causes a smaller inflammatory response of the liver tissue compared to that caused by its contact with atmospheric air during open surgery.