A comparison of the oxidative stress response in single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair

Jacek T Białecki; Waldemar Myszka; Ewa Wysocka; Sebastian Sowier; Przemysław Pyda; Ryszard Antkowiak; Łukasz Antkowiak; Anna Sowier; Zbigniew Krasiński

doi:10.5114/wiitm.2020.93202

A comparison of the oxidative stress response in single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair

Wideochir Inne Tech Maloinwazyjne. 2020 Dec;15(4):567-573. doi: 10.5114/wiitm.2020.93202. Epub 2020 Feb 24.

Authors

Jacek T Białecki¹, Waldemar Myszka², Ewa Wysocka², Sebastian Sowier¹, Przemysław Pyda³, Ryszard Antkowiak⁴, Łukasz Antkowiak⁵, Anna Sowier¹, Zbigniew Krasiński⁶

Affiliations

¹ Department of General Surgery, Franciszek Raszeja Memorial Hospital, Poznan, Poland.
² Department of Clinical Biochemistry and Laboratory Medicine, Chair of Chemistry and Clinical Biochemistry, Poznan University of Medical Sciences, Poznan, Poland.
³ Department and Clinic of General and Endocrine Surgery and Gastroenterological Oncology, Faculty of Medicine I, Poznan University of Medical Sciences, Poznan, Poland.
⁴ Department of General Surgery, Regional Health Centre, Lubin, Poland.
⁵ Department of Histology and Embryology, Medical University of Silesia, Zabrze, Poland.
⁶ Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland.

Abstract

Introduction: Surgical treatment is always associated with tissue damage and the subsequent development of oxidative stress.

Aim: To compare the oxidative stress response in patients treated operatively for inguinal hernia with multi-trocar laparoscopic totally extraperitoneal technique (TEP) or single-incision laparoscopic totally extraperitoneal technique (TEP-SI).

Material and methods: A randomized group of 34 patients with one-sided inguinal hernia was enrolled in the study. Seventeen patients were treated with a standard TEP method (group 1) and the other 17 patients were treated with the TEP-SI technique (group 2). Thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAS) as the oxidative stress markers were measured before surgery (0), 1 day (1) and 4 days (2) after surgery.

Results: A decrease in TAS on the first day after surgery was observed in both groups. Sustained reduction on the fourth day after surgery was observed in group 1, whereas in group 2 an increase followed. A statistically significant difference was observed in TAS (2 : 0) ratio with a meaningful decrease in group 1. TBARS concentration was elevated 1 day after surgery in both groups. It remained at an elevated level on the fourth day after surgery in group 1, while it decreased in group 2. The duration of surgery was higher in group 2 (mean: 57.5 min) than in group 1 (mean: 50.0 min) (p = 0.0286).

Conclusions: Oxidative stress levels are lower in patients treated operatively by TEP-SI technique than by TEP. TEP-SI may be considered as a less invasive technique associated with less tissue injury.

Keywords: inguinal hernia repair; minimally invasive surgery; oxidative stress; single-incision laparoscopic surgery.