A comparison of the oxidative stress response and antioxidant capacity of open and laparoscopic hernia repairs

J Laparoendosc Adv Surg Tech A. 2003 Jun;13(3):167-73. doi: 10.1089/109264203766207681.


Background: Free radical-induced lipid peroxidation that is associated with a decrease in the antioxidant status of plasma occurs in many kinds of surgical procedures. In this study, we aimed to investigate markers of oxidative stress--malondialdehyde (as thiobarbituric acid reactive substances), protein carbonyls, and protein sulfhydryls--in patients undergoing Lichtenstein tension-free hernioplasty (LH) or laparoscopic preperitoneal hernia (LPPH) repair.

Methods: Seventeen patients with unilateral inguinal hernia and no complications or recurrence were included in this study. Ten were randomized to undergo LH and seven to LPPH repair. Heparinized blood samples were taken to measure the levels of oxidative stress markers in the patients undergoing hernia repair. Levels of malondialdehyde, protein carbonyls, and protein sulfhydryls were measured preoperatively and at 6 and 24 hours postoperatively in all patients.

Results: Both types of hernia repair caused a significant increase in the oxidative stress response and a decrease in antioxidant activity. Plasma levels of malondialdehyde and carbonyls (indicators of oxidant activity) were significantly higher in the LH than in the LPPH repair group (P<.05), and plasma sulfhydryl levels (indicators of antioxidant activity) were significantly lower in the LH than in the LPPH group (P<.05). In both groups, significant differences were also found between the preoperative levels and the postoperative levels 6 and 24 hours (P<.05).

Conclusions: These data demonstrate that both LH and LPPH repair cause a significant increase in markers of oxidative stress; however, the oxidative stress response associated with LH is greater than that associated with LPPH repair.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Antioxidants / metabolism*
  • Biomarkers / blood
  • Digestive System Surgical Procedures
  • Female
  • Hernia, Inguinal / blood
  • Hernia, Inguinal / surgery*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Malondialdehyde / blood
  • Middle Aged
  • Oxidative Stress / physiology*


  • Antioxidants
  • Biomarkers
  • Malondialdehyde