Surgical Endoscopy

, Volume 23, Issue 3, pp 534–538 | Cite as

The effect of pentoxifylline on oxidative stress in CO2 pneumoperitoneum

  • Ayhan Dinckan
  • Emel Sahin
  • Mehmet Ogus
  • Kemal Emek
  • Saadet Gumuslu



Carbon dioxide (CO2) pneumoperitoneum induces peritoneal oxidative stress. This experimental, randomized, controlled study was designed to investigate the effect of pentoxifylline on oxidative stress induced by CO2 pneumoperitoneum.


For this study, 36 Swiss albino rats were randomized into three groups. Arteria, vena femoralis, and peritoneal cavity were cannulated after anesthesia. The arterial pH, partial arterial oxygen pressure (PaO2), venous PO2, arterial and venous PO2 difference (P(a-v)O2), serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), and thiobarbituric acid-reactive substances (TBARS) were studied at the end of the first and second hours in group 1 (control). In group 2, 1 cc isotonic NaCl was injected into peritoneal cavity and then CO2 pneumoperitoneum was established. At the end of the first hour of insufflation and one hour after desufflation, the same parameters as in group 1 were studied. In group 3, the CO2 pneumoperitoneum plus pentoxifylline group, all procedures as in group 2 were repeated, with the exception of pentoxifylline (50 mg/kg) injected in place of saline.


At the end of the first hour, P(a-v)O2 value in group 2 was significantly less than in the control group (group 1) and group 3 (p < 0.05). There were no significant differences in PaO2, pH, AST, and ALT values between groups (p > 0.05). TBARS level in group 1 was significantly lower than in the other groups, but there was no significant difference in TBARS level between groups 2 and 3. At the end of the second hour, TBARS level in group 3 was significantly lower than in group 2 (p < 0.05).


Pentoxifylline may reduce the oxidative injury following laparoscopic procedures.


Abdominal Carbon dioxide Pentoxifylline Oxidative stress Pneumoperitoneum 



This work was supported by Akdeniz University Research Fund, Antalya, Turkey.


  1. 1.
    Polat C, Yilmaz S, Serteser M, Koken T, Kahraman A, Dilek ON (2003) The effect of different intraabdominal pressures on lipid peroxidation and protein oxidation status during laparoscopic cholecystectomy. Surg Endosc 17:1719–1722PubMedCrossRefGoogle Scholar
  2. 2.
    de Souza AM, Wang CC, Chu CY, Lam PM, Rogers MS (2003) The effect of intra-abdominal pressure on the generation of 8-iso prostaglandin F2alpha during laparoscopy in rabbits. Hum Reprod 18(10):2181–2188PubMedCrossRefGoogle Scholar
  3. 3.
    Eleftheriadis E, Kotzampassi K, Papanotas K, Heliadis N, Sarris K (1996) Gut ischemia, oxidative stress, and bacterial translocation in elevated abdominal pressure in rats. World J Surg 20:11–16PubMedCrossRefGoogle Scholar
  4. 4.
    Glantzounis GK, Tselepis AD, Tambaki AP, Trikalinos TA, Manataki AD, Galaris DA, Tsimoyiannis EC, Kappas AM (2001) Laparoscopic surgery-induced changes in oxidative stress markers in human plasma. Surg Endosc 15:1315–1319PubMedCrossRefGoogle Scholar
  5. 5.
    Himmelfarb J, Hakim RM (2003) Oxidative stress in uremia. Curr Opin Nephrol Hypertens 12:593–598PubMedCrossRefGoogle Scholar
  6. 6.
    Muller R (1981) Hemorheology and peripheral vascular diseases: a new therapeutic approach. J Med 12(4):209–235PubMedGoogle Scholar
  7. 7.
    Porter JM, Cutler BS, Lee BY, Reich T, Reichle FA, Scogin JT, Strandness DE (1982) Pentoxifylline efficacy in the treatment of intermittent claudication: multicenter controlled double-blind trial with objective assessment of chronic occlusive arterial disease patients. Am Heart J 104(1):66–72PubMedCrossRefGoogle Scholar
  8. 8.
    Windmeier C, Gressner M (1997) Pharmalogical aspects of pentoxifylline with emphasis on its inhibitory actions on hepatic fibrogenesis. Gen Pharmac 29(2):181–196Google Scholar
  9. 9.
    Hammerman C, Goldschimidt D, Caplan MS, Eidelman AÝ, Branki D, Hochman A (1999) Amelioration of ischemia-reperfusion injury in rat intestine by pentoxifylline-mediated inhibition of xanthine oxidase. J Pediatr Gastroenterol Nutr 29:69–74PubMedCrossRefGoogle Scholar
  10. 10.
    Savas C, Aras T, Cakmak M, Bilgehan A, Ataoğlu O, Türközkan N, Ozgüner F, Yücesan S, Dindar H (1997) Pentoxifylline inhibits overflow and reduces intestinal reperfusion injury. J Pediatr Surg 32(6):905–910PubMedCrossRefGoogle Scholar
  11. 11.
    Wasowicz W, Neve J, Peretz A (1993) Optimized steps in fluorometric determination of thiobarbituric acid-reactive substances in serum: importance of extraction pH and influence of sample preservation and storage. Clin Chem 39(12):2522–2526PubMedGoogle Scholar
  12. 12.
    Gumuslu S, Serteser M, Ozben T, Balkan S, Balkan E (1997) Inhibitory role of N omega-nitro-l-arginine methyl ester (L-NAME), a potent nitric oxide synthase inhibitor, on brain malondialdehyde and conjugated diene levels during focal cerebral ischemia in rats. Clin Chim Acta 267:213–223PubMedCrossRefGoogle Scholar
  13. 13.
    Hemadeh O, Chilukuri S, Bonet V, Hussein S, Chaudry IH (1993) Prevention of peritoneal adhesions by administration of sodium carboxymethyl cellulose and oral vitamin E. Surgery 114:907–910PubMedGoogle Scholar
  14. 14.
    Shachtrup A, Joens CH, Hoer J, Klosterhalfen B, Lawong AG, Shumpelick V (2002) A 24-h pneumoperitoneum leads to multiple organ impairment in a porcine model. J Surg Res 106(1):37–45CrossRefGoogle Scholar
  15. 15.
    Tan M, Xu FF, Pengs JS, Li DM, Chen LH, Lv BJ, Zhao ZX, Huang C, Zheng CX (2003) Changes in the level of serum liver enzymes after laparoscopic surgery. World J Gastroenterol 9(2):364–367PubMedGoogle Scholar
  16. 16.
    Giraudo G, Brachet CR, Caccetta M, Morino M (2001) Gasless laparoscopy could avoid alterations in hepatic function. Surg Endosc 15(7):741–746PubMedCrossRefGoogle Scholar
  17. 17.
    Buyukkece A, Ogus M, Oner G, Akaydın M (1998) The effect of intraabdominal pressure and carbon dioxide on tissue oxygenation. 6th World Congress of Endoscopic Surgery. In: Montori A, Lirici MM, Montori J (eds) Rome, Italy. International Proceeding Division: 11–15, June 3–6Google Scholar
  18. 18.
    Kuntz C, Wunsch A, Bodeker C, Bay F, Rosch R, Windeler J, Herfarth C (2000) Effect of pressure and gas type on intraabdominal subcutaneous and blood pH in laparoscopy. Surg Endosc 14(4):367–371PubMedCrossRefGoogle Scholar
  19. 19.
    Joris J, Hanore P, Lamy M (1992) Changes in oxygen transport and ventilation during laparoscopic cholecystectomy. Anesthesiology 77(3A):A-149Google Scholar
  20. 20.
    Yilmaz S, Koken T, Tokyol C, Kahraman A, Akbulut G, Serterer M, Polat C, Gokce C (2003) Can preconditioning reduce laparoscopy-induced tissue injury? Surg Endosc 17(5):819–824PubMedCrossRefGoogle Scholar
  21. 21.
    Yilmaz S, Ates E, Polat C, Koken T, Tokyol C, Akbulut G, Gokce O (2003) Ischemic preconditioning decreases laparoscopy induced oxidative stress in small intestine. Hepatogastroenterology 50(52):979–982PubMedGoogle Scholar
  22. 22.
    Noyan T, Onem O, Ramazan Sekeroglu M, Köseoğlu B, Dülger H, Bayram I, Yalçinkaya AS, Bakan V (2003) Effect of erythropoietin and pentoxifylline on the oxidant and antioxidant systems in the experimental short bowel syndrome. Cell Biochem Funct 21(1):49–54PubMedCrossRefGoogle Scholar
  23. 23.
    Sener G, Akgun U, Satiroglu H, Topaloglu U, Keyer-Uysal M (2001) The effect of pentoxifylline on intestinal ischemia/reperfusion injury. Fundam Clin Pharmacol 15(1):19–22PubMedCrossRefGoogle Scholar
  24. 24.
    Aslan A, Karaguzel G, Celik M, Uysal N, Yucel G, Melikoglu M (2001) Pentoxifylline contributes to the hepatic cytoprotective process in rats undergoing hepatic ischemia and reperfusion injury. Eur Surg Res 33(4):285–290PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Ayhan Dinckan
    • 1
  • Emel Sahin
    • 2
  • Mehmet Ogus
    • 1
  • Kemal Emek
    • 1
  • Saadet Gumuslu
    • 2
  1. 1.Department of Surgery, Faculty of MedicineAkdeniz UniversityAntalyaTurkey
  2. 2.Department of Biochemistry, Faculty of MedicineAkdeniz UniversityAntalyaTurkey

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