Comparison of surgical stress between laparoscopic and open colonic resections.
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.
Hildebrandt
U
U
Klinikum Salzgitter, Salzgitter, Germany. chuhil@med-rz.uni-sb.de
Kessler
K
K
Plusczyk
T
T
Pistorius
G
G
Vollmar
B
B
Menger
M D
MD
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*
D015850:Interleukin-6; D016753:Interleukin-10; D002097:C-Reactive Protein; D019272:Leukocyte Elastase