Systemic stress response after laparoscopic or open cholecystectomy: A randomized trial

Karayiannakis, Anastasios J.; Makri, G. G.; Mantzioka, A.; Karousos, D.; Karatzas, Gabriel

doi:10.1002/bjs.1800840411

Cited by 147 publications

(96 citation statements)

References 22 publications

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“…The neuroendocrine and inflammatory responses lower than that of conventional cholecystectomy may also contribute to the lower morbidity of laparoscopic cholecystectomy 24 . Mortality of LPC was relatively low: 0.31%.…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Colecistectomia videolaparoscópica em 960 pacientes idosos

Loureiro

Klein

Pavan

et al. 2011

Rev. Col. Bras. Cir.

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Results Results: operative time ranged from nine to 180 minutes. The length of stay ranged from 24 to 120 hours. Conversion occurred in 28 patients (2.92%), of which 67.9% were women and 28.6% men, a minilaparotomy having been performed in 11 cases (39.3%) and in 17 (60.7%) the conventional open route. The perioperative complications were two ruptures of the gallbladder, a failure in the pneumoperitoneum and in clipping of the cystic duct. Post-operative complications were five umbilical incisional hernias. Systemic complications were: nine arrhythmias, one postoperative jaundice, one acute myocardial infarction and one mesenteric infarction. Mortality occurred in three patients (0.3%), one due to perioperative myocardial infarction, one due to sepsis and one because of the mesenteric infarction. Conclusion Conclusion Conclusion Conclusion Conclusion: elderly patients undergoing laparoscopic cholecystectomy had low hospital stay and low morbimortality. The operative time and hospital stay were short, demonstrating that laparoscopic cholecystectomy is safe and effective in the elderly.

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Section: Results Results Results Resultsmentioning

confidence: 99%

Colecistectomia videolaparoscópica em 960 pacientes idosos

Loureiro

Klein

Pavan

et al. 2011

Rev. Col. Bras. Cir.

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“…6 A number of mediators, such as cytokines and hormones, are considered to play important roles in this response, among which IL-6, IL-10 and granulocytic elastase have been demonstrated to be useful markers reflecting surgical stress. [7][8][9][10] Therefore, in this study, we measured the serum levels of these humoral mediators to objectively compare surgical stress between laparoscopic and open surgery.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10] Methods Twenty-five patients who underwent laparoscopic surgery (laparoscopic radical prostatectomy, 10; retroperitoneoscopic nephrectomy or nephroureterectomy, seven; laparoscopic adrenalectomy, five; and handassisted laparoscopic radical nephrectomy, three) and 10 patients who underwent open surgery (retropubic radical prostatectomy, four; radical cystectomy, three; and radical nephrectomy, three) between January and August 2001, under general anesthesia, were enrolled in this study. All 35 patients had no metabolic, endocrine, hepatic or renal disease, and they were not receiving medication known to interfere with a hormonal response to stress.…”

Section: Introductionmentioning

confidence: 99%

Comparison of surgical stress between laparoscopy and open surgery in the field of urology by measurement of humoral mediators

et al. 2002

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Background: Recently, laparoscopic procedures have become more common in urological surgery, and are suggested to be less stressful compared with open surgery; however, little data on objective evaluation of surgical stress after laparoscopic surgery are available. The objective of this study was to compare surgical stress between laparoscopic and open surgery in the field of urology by measurement of humoral mediators. Methods: Blood samples were obtained from 25 patients who underwent laparoscopic surgery (laparoscopic radical prostatectomy, 10; retroperitoneoscopic nephrectomy or nephroureterectomy, seven; laparoscopic adrenalectomy, five; and hand-assisted laparoscopic radical nephrectomy, three) and 10 who underwent open surgery (retropubic radical prostatectomy, four; radical cystectomy, three; and radical nephrectomy, three), 48 h before surgery, during surgery, and 24, 48 and 96 h after surgery. Serum levels of interleukin (IL)-6, IL-10 and granulocytic elastase in these samples were measured, and the results were analyzed with respect to several clinical factors. Results: In both groups, IL-6 and granulocytic elastase levels increased during surgery and reached maximum levels 24 h after surgery; the increase in granulocytic elastase tended to be prolonged compared with that of IL-6. Changes in IL-10 levels in the open surgery group were similar to those of IL-6 and granulocytic elastase levels, whereas IL-10 levels in the laparoscopic surgery group reached a maximum level during surgery and then decreased to the same level as at 48 h before surgery, on the first postoperative day. The maximum levels of these three mediators in the laparoscopic surgery group were significantly lower than those in the open surgery group. IL-6 was closely associated with the interval of fasting and duration of hospitalization after surgery. Conclusion: Although the present study was based on retrospective and non-randomized analysis, the findings suggest that serum levels of IL-6, IL-10 and granulocytic elastase are useful as objective markers of surgical stress, and that laparoscopic surgery is markedly less stressful than open surgery.

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“…To test this hypothesis, we measured inflammatory markers in the serum of patients who had been treated surgically for herniated discs using MED, microscopic discectomy (MD) or open unilateral laminotomy. Early recovery from endoscopic surgery has been attributed to reduced local production of proinflammatory cytokines such as Interleukin-1 (IL-1), Interleukin-6 (IL-6) or tumor necrosis factor-alpha (TNF-a) [2,7,15,18]. In the present study, we collected laboratory data from patients who were treated surgically with MED for disc herniation.…”

Section: Introductionmentioning

confidence: 99%

Objective assessment of reduced invasiveness in MED

et al. 2005

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Microendoscopic discectomy (MED) has been accepted as a minimally invasive procedure for lumbar discectomy because of the small skin incision and short hospital stay required for this surgery. However, there are few objective laboratory data to confirm the reduced systemic responses in the early phase after this procedure. In order to substantiate the reduced invasiveness of MED compared to microdiscectomy (MD) or procedures involved in one-level unilateral laminotomy, the invasiveness of each surgical procedure was evaluated by measuring serum levels of biochemical parameters reflective of a postoperative inflammatory reaction and damage to the paravertebral muscles. Thirty-three patients who underwent lumbar discectomy or one-level unilateral laminotomy (MED in 15 cases, MD in 11 cases and one-level unilateral laminotomy in 7 cases with lumbar spinal canal stenosis) were included in this study. The serum levels of C-reactive protein (CRP) and creatine phosphokinase (CPK) were measured at 24 h after operation. Interleukin-6 (IL-6) and Interleukin-10 (IL-10) were measured at 2, 4, 8 and )24 h following the surgery to monitor the inflammatory response to the respective surgery. The post-operative serum CRP levels from both the MD and MED groups were significantly lower than those from the open laminotomy group. However, there was no significant difference in these serum levels between the MED and MD groups. The levels of IL-6 and IL-10 in the MED group during0 the first post-operative day were also significantly lower than those in the laminotomy group. When the MED and MD groups were compared, the IL-6 levels in the MED group were lower than in MD group at 2, 4 and 8 h after surgery, but the differences were not statistically significant. However, the level was significantly lower in the MED group at 24 h after surgery. In terms of IL-10, no significant difference was noted between the MED and MD groups over the study period. The changes in serum levels of postoperative inflammatory: markers (CRP, IL-6 and IL-10) in the early phase indicated reduced inflammatory reactions in MED as well as in MD when compared with classical open unilateral laminotomy. These data draw a direct link between the lower level of the inflammatory response and reduced invasiveness of MED. However, an indicator for muscle damage (CPK) appeared not to be affected by the type of surgical procedure used to correct disc herniation.Keywords Microendoscopic discectomy AE Microdiscectomy AE Lumbar disc herniation AE Minimally invasive surgery Eur Spine J (2006) 15: 577-582

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Systemic stress response after laparoscopic or open cholecystectomy: A randomized trial

Abstract: The neuroendocrine stress response and inflammatory response following laparoscopic cholecystectomy were significantly reduced compared with those after open cholecystectomy.

Cited by 147 publications

References 22 publications

Colecistectomia videolaparoscópica em 960 pacientes idosos

Colecistectomia videolaparoscópica em 960 pacientes idosos

Comparison of surgical stress between laparoscopy and open surgery in the field of urology by measurement of humoral mediators

Objective assessment of reduced invasiveness in MED

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