title: Systemic stress response during operations for acute abdominal pain performed via laparoscopy or laparotomy in children.
abstract: We compared the endocrine and metabolic changes during acute emergency abdominal surgery performed using either laparoscopy or laparotomy in children. Twenty-nine children aged 1.5-14 years were assigned to undergo laparoscopy (n = 15) or laparotomy (n = 14) with a standard anaesthesia technique. Arterial blood gases and blood prolactin, cortisol, interleukin-6, glucose, insulin, lactic acid and epinephrine levels were determined 5 min after the induction of anaesthesia, 30 min into surgery and at the end of surgery. Intra-operative heart rate and mean arterial pressure were stable in both groups. In the laparoscopy group, slight respiratory acidosis occurred during surgery (p < 0.01) but there were no changes in the laparotomy group. Insulin, cortisol, prolactin, epinephrine, lactate and blood glucose levels increased in both groups (p < 0.05) although there was no difference between the groups. The surgical stress and trauma imposed by laparoscopy seems similar to that caused by laparotomy in children undergoing emergency abdominal surgery.
authors.affiliation: Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
authors.forename: P
authors.initials: P
authors.lastname: Bozkurt
authors.forename: G
authors.initials: G
authors.lastname: Kaya
authors.forename: F
authors.initials: F
authors.lastname: Altintas
authors.forename: Y
authors.initials: Y
authors.lastname: Yeker
authors.forename: M
authors.initials: M
authors.lastname: Hacibekiroglu
authors.forename: H
authors.initials: H
authors.lastname: Emir
authors.forename: N
authors.initials: N
authors.lastname: Sarimurat
authors.forename: G
authors.initials: G
authors.lastname: Tekant
authors.forename: E
authors.initials: E
authors.lastname: Erdogan
mesh_terms: D015746:Abdominal Pain / Q000378:metabolism / Q000601:surgery*; D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate; D006728:Hormones / Q000097:blood; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000097:blood; D019344:Lactic Acid / Q000097:blood; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D013312:Stress, Physiological / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D006728:Hormones; D015850:Interleukin-6; D019344:Lactic Acid