Laparoscopic vs. open abdominal surgery in male pigs: Marked differences in cortisol and catecholamine response depending on the size of surgical incision

Abstract

ObJEcTIVE: Minimally invasive operations, such as laparoscopic cholecystectomy and adrenalectomy, result in a more rapid recovery of normal function, less physiological disturbances and less stress to the organism than similar open operations. The purpose of this study was to determine the stress response associated with minimally invasive abdominal surgery compared to conventional small or large incision laparotomy. METHODs: We compared the responses of the stress hormones cortisol and the catecholamines adrenaline and noradrenaline to elective conventional and laparoscopic cholecystectomy and unilateral adrenalectomy in male pigs. blood samples were taken from all animals at the same time, one day before surgery, at the beginning of the operation, every 15 minutes during surgery and on the first postoperative morning. rEsULTs: Plasma adrenaline and noradrenaline concentrations were significantly lower in both cholecystectomies (p<0.05) and adrenalectomies (p<0.01) during laparoscopic than during open surgery. Plasma cortisol levels were significantly lower in laparoscopic than in open adrenalectomies both during surgery and on postoperative day one (p<0.05), while no major differences in cortisol levels were observed between laparoscopic and open cholecystectomies. Thus, the stress-related benefit of laparoscopic surgery depended on the size of the surgical incision in the conventional operation. cONcLUsION: Laparoscopic surgery was associated with less surgical stress than open surgery and this difference was accentuated as the surgical abdominal wall trauma increased.

Hemodynamic changes and stress response during BIS-guided TCI anesthesia with propofol-fentanyl in laparoscopic versus open cholecystectomy

“…A study held by Krikri and his colleagues on male pigs showed that plasma adrenaline and noradrenaline concentrations were significantly lower during laparoscopic cholecystectomies and adrenalectomies than the open surgeries. These results meet ours although it is an experimental animal study with different anesthetic techniques [33]. Our results showed that norepinephrine and epinephrine levels have a similar increase reaching their maximum 2-h after surgery and dropping down afterward in open surgery group.…”

Effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy

“…Surgical stress could cause a spectrum of changes in the body, involving the neuroendocrine, metabolic, immunological, and hematological systems[ 12 ]. The body’s surgical stress response is mainly determined by the surgical wound severity, including the length of the incision in the abdominal wall from the skin to the parietal peritoneum[ 19 ]. The incision of open hepatectomy often exceeds 20 cm, and the surgical stress is thought to be high.…”

Comparison of standard and fast track rehabilitation in patients with acute appendicitis. Intermediate results of multicenter prospective randomized trial

“…В эксперименте А. Krikri и соавт. [28] концентрация кортизола при открытых и лапароскопических холецистэктомиях не различалась, в то время как при открытой и лапароскопической адреналэктомии различия были достоверными. А. Veenhof и соавт.…”