Metabolic responses after laparoscopic or open hernia repair.
BACKGROUND
The purpose of a prospective randomized study was to compare the surgical trauma in patients undergoing laparoscopic or open hernia repair.


METHODS
Postoperative pain, analgesic consumption, and metabolic response to surgery were assessed in 30 patients undergoing laparoscopic (group 1; n = 15) or open (group II; n = 15; Shouldice repair) unilateral inguinal hernia repair. Both groups were comparable with respect to age, sex, and type and size of inguinal hernia.


RESULTS
Postoperative visual analogue scales (VAS) for pain were reduced on mobilization for patients of group I with a significant difference (P = 0.02) on the operative day, whereas pain scores at rest and analgesic requirements were similar for both groups. No differences between groups I and II were found in postoperative levels of interleukin-1, interleukin-6, tumor necrosis factor alpha, C-reactive protein, fibrinogen, transferrin, alpha-1-antitrypsin, and white blood cells. Postoperative polymorphonuclear (PMN) elastase concentrations remained within normal range in group II but showed a significant increase in patients operated laparoscopically for postoperative days 1 and 2.


CONCLUSIONS
No major surgical trauma was found after herniorraphy compared to open hernia repair.
Schrenk
P
P
Second Department of Surgery and Ludwig Boltzmann Institute for Surgical Laparoscopy, AKH Linz, Krankenhausstrasse 9, A-4020 Linz, Austria.
Bettelheim
P
P
Woisetschläger
R
R
Rieger
R
R
Wayand
W U
WU
D000209:Acute-Phase Proteins / Q000378:metabolism*; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D016207:Cytokines / Q000097:blood*; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000097:blood*; D010535:Laparoscopy / Q000009:adverse effects*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D011446:Prospective Studies
D000209:Acute-Phase Proteins; D000700:Analgesics; D016207:Cytokines