[Assessment of serum lipid peroxide levels and antioxidant status in females who had undergone total abdominal hysterectomy without closing of the peritoneum].

INTRODUCTION: Reactive oxygen species (ROS) generated after the trauma caused by surgical intervention, have the capacity to react in an indiscriminate manner leading to damage to almost any cellular component (proteins, nucleid acids) and to lipid peroxidation. The assessment of ROS generation intensity process may help in understanding of molecular processes observed in the intracellular environment after operations. The evaluation of antioxidative level may give an answer about the efficiency of antioxidative defence mechanism. The peritoneum is an organ of high metabolic activity, connected with ROS generation and participated in healing process. The modern opinions suggest closing of postoperative wound without closing of peritoneum. The aim of this study was assessment of antioxidant status and serum lipid peroxide levels in early postoperative period, in females who had undergone total abdominal hysterectomy without closing of peritoneum.
MATERIALS AND METHODS: 30 women after total abdominal hysterectomy with salpingooophorectomy were studied, including 13 patients after peritoneal suturing (control group--C) and 17 women with nonclosed peritoneum (study group--S). The total serum antioxidant status (FRAP) was evaluated spectrophotometrically. The concentration of lipid peroxidation products was assessed in serum collected before operation and 8 and 24 hours after, as the concentration of lipid hydroxyperoxides (HPETE), malonyl dialdehyde (MDA) and 4-hydroxyalkenals (4-HDA).
RESULTS: The antioxidative level before operation was 1147.09 +/- 93.6 microM/l in S group; 1022.04 +/- 115.4 microM/l in C group and did not changed significantly in early postoperative period. MDA + 4-HDA level before operation was 1.08 +/- 0.2 microM/l in S group and 1.06 +/- 0.2 microM/l in C group; HPETE level before operation was 4.58 +/- 0.1 microM/l in S group and 4.72 +/- 0.1 microM/l in C group, 8 and 24 hours after the operation MDA + 4-HDA level increased respectively to 1.34 +/- 0.2 microM/l (by 27%; p > 0.05) and 1.46 +/- 0.2 microM/l (37%) in S group and to 1.16 +/- 0.2 microM/l (by 8%) and 1.62 +/- 0.2 microM/l (by 52%; p < 0.05) in C group. HPETE level decreased to 4.56 +/- 0.1 microM/l (by 1%) and increased to 5.23 +/- 0.2 microM/l (by 14%) in S group and increased respectively to 6.0 +/- 0.2 microM/l (by 27%; p < 0.01) and to 6.43 +/- 0.2 microM/l (by 36%; p < 0.01) in C group.
CONCLUSIONS: The concentration of lipid peroxidation products after the operation was lower in study group, where peritoneum was left without closing. Total antioxidative level was the same in both groups. Obtained results suggest smaller ROS generation in study group.