Randomized clinical trial comparing inflammatory and angiogenic response after open <i>versus</i> laparoscopic curative resection for colonic cancer

Pascual, Marta; Alonso, Sandra; Parés, David; Courtier, Ricard; Gil, María José; Grande, Luís; Pera, Miguél

doi:10.1002/bjs.7258

Cited by 82 publications

(58 citation statements)

References 39 publications

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“…Based on Pascual et al data from a colon cancer study, transient inflammation can be both local and systemic [7]. They measured the proinflammatory cytokine interleukin-6 (IL-6) in serum prior to surgery and in peritoneal fluid during surgery to establish baseline IL-6, and again at 4, 12, 24 and 48 hours and at 4 days after surgery to determine a temporal trend.…”

Section: Discussionmentioning

confidence: 99%

NSAID analgesic ketorolac used perioperatively may suppress early breast cancer relapse: particular relevance to triple negative subgroup

Retsky

Rogers

Demicheli

et al. 2012

Breast Cancer Res Treat

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Section: Discussionmentioning

confidence: 99%

NSAID analgesic ketorolac used perioperatively may suppress early breast cancer relapse: particular relevance to triple negative subgroup

Retsky

Rogers

Demicheli

et al. 2012

Breast Cancer Res Treat

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“…However, laparoscopic right colectomy continues to be utilized in a minority of procedures [4]. This is despite the ample evidence in the literature showing improved outcomes with laparoscopic resection [5,6]. The majority of laparoscopic right colectomies continue to be performed with an extracorporeal anastomosis (EA) due to inherent technical difficulties in acquiring advanced laparoscopic suturing skills [7].…”

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confidence: 99%

Laparoscopic right hemicolectomy: short- and long-term outcomes of intracorporeal versus extracorporeal anastomosis

et al. 2015

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Background The use of laparoscopy for right hemicolectomy has gained popularity allowing the option of a totally laparoscopic intracorporeal anastomosis (IA) for intestinal reconstruction. This technique may alleviate some of the technical limitations that a surgeon faces with a laparoscopic-assisted extracorporeal anastomosis (EA). Results A total of 195 patients underwent laparoscopic right hemicolectomy over the study period, with 86 (44 %) patients receiving IA and 109 (56 %) patients receiving an EA. The most common indication for surgery in both groups was cancer: 56 (65 %) of IA cases and 57 (52 %) of EA cases. IA had a significantly higher rate of minor complications but no difference in serious complications compared to EA. Conversion to open resection was higher in EA. Using multivariate analysis to compare IA versus EA, there was no significant difference in length of stay, return of bowel function, risk of anastomotic leak, risk of intraabdominal abscess or risk of wound complications. Amongst cancer resections, there was no significant difference in the median number of lymph nodes harvested (18 LNs in IA group vs. 19 LNs in EA group, P > 0.05). There was also no significant difference in overall survival and disease-free survival at 5.7 years between the two groups. MethodsConclusions IA in laparoscopic right hemicolectomy is associated with similar postoperative and oncologic outcomes compared to EA. IA may possess advantages in terms of conversion and flexibility of specimen extraction, but this is counterbalanced by a higher incidence of minor complications. These findings suggest that IA represents a valid technique in the arsenal of the experienced colorectal surgeon without compromising outcomes.

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“…3,4 Also, cellular immune responses appear to be less affected by laparoscopic colorectal resection compared with open resection as determined by total lymphocyte count, CD4 þ and CD8 þ T cells, interferon-c, and human leukocyte antigen-DR. [5][6][7][8] However, these differences are not consistent at all time intervals, and further studies are needed to fully characterize the importance of temporal changes in these markers. Furthermore, despite potential benefits, laparoscopic surgery still remains technically challenging in rectal cancer and will not be suitable for all patients.…”

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confidence: 99%

Surgical Stress Response After Colorectal Resection

Andersson

Ansari

Nordén

et al. 2013

International Surgery

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The human body's response to surgery is correlated with the extent of tissue damage. The aim of the present study was to, over time, map out parameters concerning inflammation, metabolism, nutrition, breathing function, muscle strength, and well-being in elective colorectal surgery. Eighteen patients were prospectively included: colon resection (n ¼ 9) and rectum resection/amputation (n ¼ 9). Postoperative interleukin 10 (IL-10) rose more in the rectum surgery group on day 0 (P ¼ 0.007) and day 3 (P ¼ 0.025). Furthermore, significant differences between groups were detected regarding albumin, prealbumin, and total iron-binding capacity (TIBC). For albumin and TIBC, this difference was seen even on day 7. C-reactive protein, IL-6, IL-8, glucose, cortisol, insulin, pain, fatigue, nausea, grip strength, and forced expiratory volume in 1 second did not show any differences. No correlation was revealed between measured parameters and postoperative complications. Postoperative levels of IL-10, albumin, prealbumin, and TIBC may be used as determinants of surgical stress after colorectal surgery.

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Randomized clinical trial comparing inflammatory and angiogenic response after open versus laparoscopic curative resection for colonic cancer

Abstract: ISRCTN55624793 (http://www.controlled-trials.com).

Cited by 82 publications

References 39 publications

NSAID analgesic ketorolac used perioperatively may suppress early breast cancer relapse: particular relevance to triple negative subgroup

NSAID analgesic ketorolac used perioperatively may suppress early breast cancer relapse: particular relevance to triple negative subgroup

Laparoscopic right hemicolectomy: short- and long-term outcomes of intracorporeal versus extracorporeal anastomosis

Surgical Stress Response After Colorectal Resection

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