title: Comparison of surgical stress between laparoscopic and open colonic resections.
abstract: BACKGROUND
  The magnitude of surgical trauma after laparoscopic and open colonic resection was evaluated by examining postoperative serum values of interleukin-6 (IL-6), IL-10, C-reactive protein (CRP), and granulocyte elastase (GE) for further evidence of the benefit realized with minimally invasive approaches in colonic surgery.
  
  
  METHODS
  Altogether, 42 patients with Crohn's disease (n = 20) or colon carcinomas/adenomas (n = 22) were matched by age, gender, body mass index (BMI), and Crohn's Disease Activity Index for either a laparoscopic (n = 21) or an open colonic resection (n = 21). In both groups the postoperative serum levels of IL-6, IL-10, C-RP, and granulocyte elastase were determined, as indicators of surgical stress.
  
  
  RESULTS
  Laparoscopic and open colonic resection caused a significant increase in serum IL-6, IL-10, CRP, and granulocyte elastase levels. The comparison between laparoscopic and open colonic resections, however, showed significantly lower serum IL-6, IL-10, CRP, and granulocyte elastase levels after laparoscopic colonic resection, which was most evident for IL-6 and granulocyte elastase.
  
  
  CONCLUSIONS
  Our study demonstrated that IL-6 and granulocyte elastase may be appropriated particularly to monitor surgical stress. By using these parameters, we found a significant reduction in surgical trauma after laparoscopic surgery, was compared with the open procedure. This supports the clinical findings of a clear benefit for patients undergoing laparoscopic colonic surgery.
authors.affiliation: Klinikum Salzgitter, Salzgitter, Germany. chuhil@med-rz.uni-sb.de
authors.forename: U
authors.initials: U
authors.lastname: Hildebrandt
authors.forename: K
authors.initials: K
authors.lastname: Kessler
authors.forename: T
authors.initials: T
authors.lastname: Plusczyk
authors.forename: G
authors.initials: G
authors.lastname: Pistorius
authors.forename: B
authors.initials: B
authors.lastname: Vollmar
authors.forename: M D
authors.initials: MD
authors.lastname: Menger
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D003082:Colectomy / Q000009:adverse effects*; D003110:Colonic Neoplasms / Q000097:blood / Q000601:surgery*; D003424:Crohn Disease / Q000097:blood / Q000601:surgery*; D005260:Female; D006098:Granulocytes / Q000201:enzymology; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D010535:Laparoscopy / Q000009:adverse effects*; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D013312:Stress, Physiological / Q000097:blood* / Q000209:etiology*
chemical_list: D015850:Interleukin-6; D016753:Interleukin-10; D002097:C-Reactive Protein; D019272:Leukocyte Elastase