Does CO₂ Pneumoperitoneum Alter the Ultra-Structuture of the Mesothelium?

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• 作者：Marcos T.A. Rosá ; rio ; Ulysses Ribeiro ; Jr ; Carlos E.P. Corbett ; Alberto C. Ozaki ; Clá ; udio C. Bresciani ; Bruno Zilberstein and Joaquim J. Gama-Rodrigues
• 刊名：Journal of Surgical Research
• 出版年：2006
• 期刊代码：299_00224804
• 类别：med
• 出版时间：15 June 2006
• 卷：133
• 期：2
• 页码：84-88
• 文件大小：230 K

摘要

Background

Pneumoperitoneum may be responsible for ultra-structural alterations in the mesothelium during laparoscopy. To characterize the effect of pneumoperitoneum on the mesothelial cells with CO₂ and compressed air; and to compare to laparotomy and control group (anesthesia only).

Materials and methods

Forty C-57 mice were divided in four groups of 10 animals each: CO₂, air, laparotomy, and control group. The animals were submitted to pneumoperitoneum at 8 mmHg during 30 min (CO₂ or compressed air). Five animals of each group were sacrificed 2 and 24 h after the procedure. Fragments of parietal peritoneum were collected and processed for scanning electron microscopy.

Results

Control group revealed uninterrupted mesothelial cells, without any evidence of cellular limits; close contact between the cells; absence of intercellular clefts and presence of microvilli. In the laparotomy group, similar results to the control group, with decreased microvilli were noted. Air pneumoperitoneum was associated with alterations in the morphology of the mesothelial cells, clear cellular limits, and cells with spherical and fusiforme formats. CO₂ pneumoperitoneum showed mesothelial cells with clear cellular limits, predominantly spherical cellular format, and intercellular clefts that allowed the visualization of the exposed basal membrane. These alterations were more intense after 24 h. There was a statistical significance between CO₂ group (2 and 24 h) compared to the control group and laparotomy for cellular limits, intercellular clefts and microvilli, P < 0.0001.

Conclusions

Pneumoperitoneum causes damage in the mesothelial ultra-structure, which differs from the laparotomy group. CO₂ pneumoperitoneum is more harmful to the mesothelium than the air.