Surgical Stress Response and Postoperative Immune Function After Laparoscopy or Open Surgery With Fast Track or Standard Perioperative Care

Veenhof, A. A. F. A.; Vlug, Malaika S.; Pas, M. H. G. M. van der; Sietses, C.; Peet, Donald L. van der; Klerk, Elly S.M. de Lange–de; Bonjer, H. Jaap; Bemelman, Willem A.; Cuesta, Miguel A.

doi:10.1097/sla.0b013e31824336e2

Cited by 299 publications

(245 citation statements)

References 15 publications

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“…The LAFA study looked at four groups of surgical patients undergoing colorectal surgery: (1) open surgery within an ERP, (2) open surgery without an ERP, (3) laparoscopic surgery within an ERP, and (4) laparoscopic surgery without an ERP. 32 IL-6 and C-reactive protein levels were highest in the open surgery group, as expected. The biggest impact on improving postoperative immune function (measured by effect on HLA-DR) was having laparoscopic surgery and the addition of an ERP improved this further.…”

Section: Evidence Base For Enhanced Recovery Pathwayssupporting

confidence: 62%

Pathophysiology of Major Surgery and the Role of Enhanced Recovery Pathways and the Anesthesiologist to Improve Outcomes

Scott

Miller

2015

Anesthesiology Clinics

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KEYWORDSEnhanced recovery pathway Fast-track surgery Anesthesia Perioperative care Pathophysiology of surgery Stress response to surgery Metabolic response to surgery Minimally invasive surgery KEY POINTSEnhanced recovery pathways aim to reduce the stress response and improve the metabolic response to surgery restoring the patient to preoperative function more quickly.It is increasingly recognized that rapid, uncomplicated, recovery reduces not only the cost and length of stay of the patient episode but medical and possibly surgical related complications. Provided defined discharge criteria are met readmission rates are not increased.Minimally invasive surgery is a key component of enhanced recovery to reduce the primary injury of tissue damage and blood loss, which both drive the stress response and metabolic response to surgery.All elements of an enhanced recovery pathway are important because they interact positively with each other, a term likened to the sum of small gains.The anesthesiologist plays a key role in optimizing surgical outcomes by controlling a patient's physiology throughout the perioperative pathway.Anesthesiology Clin 33 (2015) 79-91 http://dx

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Section: Evidence Base For Enhanced Recovery Pathwayssupporting

confidence: 62%

Pathophysiology of Major Surgery and the Role of Enhanced Recovery Pathways and the Anesthesiologist to Improve Outcomes

Scott

Miller

2015

Anesthesiology Clinics

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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.…”

mentioning

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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“…IL-6 is used as postoperative complications and predictor of morbidity. Veenhof et al (12) reported that the patients who underwent laparoscopic surgery were affected positively at HLA-DR, CRP and IL-6 levels. Early recovery, early onset bowel motility, and short hospitalization may be associated with these effects in patients undergoing laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Longterm and Perioperative Outcomes of Laparoscopic and Open Surgery for Rectal Cancer

et al. 2018

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ABSTRACT:Longterm and perioperative outcomes of laparoscopic and open surgery for rectal cancer Objective: The necessity of comparing oncologic results with the use of minimally invasive surgery in rectal cancer has arisen. We aimed to evaluate our treatment approach in rectal cancer and compare the outcomes of laparoscopic and open surgery. Methods: Patients who underwent surgery for rectal carcinoma between January 2006 and January 2016 in our institution wasevaluated. The results were compared between two groups according to open or laparoscopic surgery. Clinical characteristics, preoperative and postoperative results; pathologic examination results and disease-free survival rates were compared after the surgical procedure. Results: A total of 121 patients were included in the study. 50 patients were undergone open and 71 patients were undergone laparoscopic surgery. The median follow-up time was 56.75 months inopen surgery group, andthe median follow-up time of the patients was 55.2 months in thelaparoscopic surgery group. Pathologic examination revealed similar numbers of lymph nodes in both groups (p>0.05). Duration of hospital stay was statistically significantly lower than the open surgery group from the laparoscopic group (p<0.05). The rate of disease-free survival was 74% in the open surgery group and 82.5% in the laparoscopic group and no statistically significant difference was found (p>0.05). Rektal kanser için laparoskopik ve açık cerrahinin uzun süreli ve perioperatif sonuçları Amaç: Rektum kanserinde minimal invaziv cerrahinin kullanımı ile onkolojik sonuçların karşılaştırıl-ması gerekliliği ortaya çıkmıştır. Rektum kanserinde tedavi yaklaşımımızı değerlendirmek, laparoskopik ve açık cerrahi sonuçlarını karşılaştırmayı amaçladık. Gereç ve Yöntem: Ocak 2006-Ocak 2016 yılları arasında kliniğimizde rektum karsinomu nedeniyle ameliyat edilen hastalar değerlendirildi. Sonuçlar açık ve laparoskopik cerrahi olarak iki grup arasın-da karşılaştırıldı. Cerrahi girişim sonrası klinik özellikler, preoperatif ve postoperatif sonuçlar; patolojik inceleme sonuçları ve hastalıksız sağkalım süreleri karşılaştırıldı. Bulgular: Çalışmaya toplam 121 hasta dahil edildi. 50 hastaya açık, 71 hastaya laparoskopik cerrahi uygulandı. Açık cerrahi grubunda medyan takip süresi 56.75 ay; laparoskopik cerrahi grubunda hastaların medyan takip süresi 55.2 aydı. Patolojik incelemede her iki grupta benzer sayıda lenf nodu saptandı (p>0.05). Hastanede yatış süresi laparoskopik cerrahi grubunda açık cerrahi grubuna göre istatistiksel olarak anlamlı derecede düşük bulundu (p<0.05). Hastalıksız takip süresi açık cerrahi grubunda %74, laparoskopik cerrahi grubunda %82.5'idi ve istatistiksel olarak anlamlı farklılık olmadığı görüldü (p>0.05). Sonuç: Çalışmamızda rektum karsinomu için laparoskopik ve açık cerrahi arasında komplikasyon ve rekürrens açısından anlamlı farklılık olmadığı görüldü. Laparoskopik cerrahi grubunda bulunan hastaların hastanede kalış süresi açık cerrahi grubundan istatistiksel olarak anlamlı derecede düşüktü.

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Surgical Stress Response and Postoperative Immune Function After Laparoscopy or Open Surgery With Fast Track or Standard Perioperative Care

Cited by 299 publications

References 15 publications

Pathophysiology of Major Surgery and the Role of Enhanced Recovery Pathways and the Anesthesiologist to Improve Outcomes

Pathophysiology of Major Surgery and the Role of Enhanced Recovery Pathways and the Anesthesiologist to Improve Outcomes

Surgical Stress Response After Colorectal Resection

Longterm and Perioperative Outcomes of Laparoscopic and Open Surgery for Rectal Cancer

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