Effect Of Laparoscopic Surgery On Morphology And Cytokines And Adhesion Molecule Of The Peritoneum

Objective: To explore internal environment of human abdominal cavity in gynecologic laparoscopic surgery. Methods: gynecologic patients were randomized to operate by laparoscopic surgery or laparotomy surgery, the peritoneum was resected in different time, which was examined by electron microscopy for morphologic changes of peritoneal mesothelial cells, and by RT-PCR and ELISA to detect cytokine, and byimmunohistochemistry staining for the expression of adhesion molecule. Results: In 2h,bulging up of mesothelial cells, breakage of cell-cell junction, and naked underlying basal lamina were found in laparoscopic surgery, which were associated with time of insufflation. The expression of IL-6 and IL-8 decreased in laparoscopic surgery (P<0.05).The expression of IL-6 and IL-8 increased in laparotomy surgery (P<0.01). There was statistically difference of the expression of IL-6 at 60min (P<0.05) and significant difference at 90min and 120min (P<0.01) between two groups, There was statistically difference of the expression of IL-8 at 90min (P<0.05) and 120min (P<0.01). They were lower than those in laparotomy surgery. The expression of ICAM-1 is higher in laparoscopic surgery group than in open surgery group (P<0.05). Conclusion: Internal environment of human abdominal cavity in gynecologic laparoscopic surgery changed, which could benefit to metastases of malignant tumor.