Peritoneal transforming growth factor beta-1 expression during laparoscopic surgery: A clinical trial

Background: Transforming growth factor-beta 1 (TGF-β1) is a growth factor involved in various biologic processes, including peritoneal wound healing and dissemination of malignancies. Laparoscopic surgery is evolving rapidly, and indications are increasing. The peritoneal TGF-β1 expression during laparoscopic surgery is unknown.

Methods: For this study, 50 patients scheduled for laparoscopic cholecystectomy were randomized into five groups, then surgically treated with various pressures, light intensities, and dissection devices. Peritoneal biopsies were taken at the beginning and end of surgery. Tissue concentrations of total and active TGF-β1 were measured using enzyme-linked immunosorbent assay (ELISA) techniques.

Results: There was no significant difference in either total or active TGF-β1 concentration between peritoneal biopsies taken at the start of surgery and samples taken at the end of the procedure. Patients who underwent surgery with the ultrasonic scalpel had significant lower levels of both active (p < 0.005) and total (p < 0.01) TGF-β1 at the end of surgery than patients treated with electrocautery. Patients who had surgery with a high light intensity had significantly lower levels of total TGF-β1 levels (p < 0.005) with an unchanged active part than patients who had surgery with low light intensity.

Conclusion: The choice of dissection device and the light intensity used in laparoscopic surgery affect peritoneal TGF-β1 concentrations, indicating that peritoneal biology can be affected by laparoscopic surgery. Because TGF-β1 is involved in various biologic processes in the peritoneal cavity, this observation may have important clinical consequences.