Systemic stress responses after laparoscopic or open hernia repair.
OBJECTIVE
To compare systemic stress responses after laparoscopic and open hernia repair to find out if the laparoscopic approach caused less stress than an open operation.


METHODS
Prospective randomised trial.


METHODS
Teaching hospital, Sanliurfa, Turkey.


METHODS
50 patients who required preperitoneal hernia repair were randomised to be treated by either the open or laparoscopic approach (n = 25 in each).


METHODS
Samples of venous blood were taken before operation and at 2, 24, and 48 hours afterwards for measurement of the concentrations of: glucose, cortisol, malonyldialdehyde (MDA), C-reactive protein (CRP), creatine phosphokinase (CPK), caeruloplasmin, transferrin, fibrinogen, and albumin, and counts of leucocytes, neutrophils, and lymphocytes.


METHODS
Changes in these indicators of a stress response.


RESULTS
Concentrations of glucose, cortisol, CRP, MDA, and CPK, and counts of leucocytes and neutrophils increased significantly, and the concentration of albumin decreased significantly, in both groups postoperatively. Lymphocyte counts were lower postoperatively but not significantly so. Concentrations of CRP, MDA, and CPK, and leucocyte counts were significantly lower in the laparoscopic group.


CONCLUSIONS
These findings suggest that there is less systemic stress response after laparoscopic than after open hernia repair.
Uzunköy
A
A
Department of General Surgery, Harran University School of Medicine, Sanliurfa, Turkey.
Coskun
A
A
Akinci
O F
OF
Kocyigit
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011486:Protein C / Q000502:physiology; D013312:Stress, Physiological / Q000209:etiology* / Q000503:physiopathology
D011486:Protein C; D003402:Creatine Kinase