Laparoscopic procedures impact on mast cell mediators, extracellular matrix and adhesion scoring system in rats

Abstract

Background Laparoscopic procedures under certain pressure have the potential to cause intra-abdominal adhesions. However, the pathomechanism of this disorder is unknown. Release of mast cell mediators due to mast cell degranulation is thought to be the cause. Materials and methods Thirty male Sprague-Dawley rats were grouped into five groups (n = 6 per group): one control group and four intervention groups to which 60 min insufflation was performed using carbon dioxide at 5, 8, 10 and 12 mmHg. Seven days after laparoscopy, we euthanized and evaluated the levels of histamine, tryptase, and chymase of peritoneal fluid, the thickness of ECM of peritoneal tissue, and intraabdominal adhesion scoring system. Results Histamine and tryptase levels in peritoneal fluid were significantly higher at the 10- and 12 mm Hg intervention compared to control (histamine: 0.50 ± 0.35 vs. 0.41 ± 0.41 vs. 0.04 ± 0.02 ng/mL, respectively; and tryptase: 0.69 ± 0.11 vs. 0.65 ± 0.05 vs. 0.48 ± 0.02 ng/ml respectively). The ECM was significantly thicker in the intervention groups at 10- and 12-mm Hg compared to control (71.3 [66.7–85.2] vs. 48.4 [34.5–50.3] vs. 10.25 [8.7–12.1] μm, respectively). Moreover, the intra-abdominal scoring was also significantly higher in the intervention groups at 10- and 12 mm Hg compared to control (4 [0–4] vs. 4.5 [4–5], vs. 0, respectively). Conclusions Laparoscopic procedures increase the release of mast cell mediators in peritoneal fluid, the thickness of ECM and intraabdominal adhesion scoring in rats, implying that it might increase the possibility of intrabdominal adhesion in humans.

Effect of ketorolac tromethamine combined with dezocine prior administration on hemodynamics and postoperative analgesia in patients undergoing laparoscopic hernia repair

“…In the present study, patients undergoing hernia repair under general anesthesia were selected for total intravenous anesthesia, and the effects of ketorolac tromethamine or dezocine alone or in combination on intraoperative hemodynamics and postoperative analgesia and sedation were considered. Hernia repair can stimulate the body to produce 5-hydroxytryptamine, [ 13 ] bradykinin, [ 14 ] histamine, [ 15 ] and other bioactive substances, as well as the accumulation of prostaglandin [ 16 ] and oxidative stress, [ 17 ] which will greatly enhance the pain caused by these substances. Although the incidence of pain in laparoscopic inguinal hernia repair is lower than that of traditional open surgery, the incidence of postoperative chronic pain is 12.7%, of which 83.3% of patients’ pain is located in the groin area.…”

Mast cell activation syndrome: An up-to-date review of literature

“…Activated mast cells and T lymphocytes release cytokines that increase intestinal permeability[ 37 ]. This leads to a vicious cycle in which intestinal permeability is constantly impaired and inflammation is constantly increased[ 36 , 38 ].…”

“…In mice, abdominal surgeries such as colorectal surgery as well as laparoscopic procedures are known to increase the release of mast cell mediators in peritoneal fluid, extracellular matrix thickness and the risk of intra-abdominal adhesions. This suggests that it may increase the likelihood of intra-abdominal adhesions such as postoperative ileus in humans[ 38 ].…”