Minilaparotomy may be independently associated with reduction in inflammatory responses after resection for colorectal cancer.
OBJECTIVE
A minilaparotomy approach (skin incision less than 7 cm) to resection of colon cancer is technically feasible, but objective data supporting its benefit are scarce. The aim of this study was to clarify whether minilaparotomy is independently associated with a reduction in the acute inflammatory response after resection of colorectal cancer.


METHODS
Thirty-one patients who underwent surgical resection of colorectal cancer using minilaparotomy or conventional laparotomy were included in this nonrandomized prospective study. Inflammatory responses were evaluated with serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels.


RESULTS
In both the minilaparotomy and conventional laparotomy groups, serum IL-6 and CRP levels significantly increased 24 h after the operation (1POD) compared to preoperative levels (p < 0.0001 and p < 0.0001, respectively). Median serum levels of IL-6 and CRP in the minilaparotomy group were significantly lower at 1POD versus the conventional group (p = 0.0066 and p = 0.0033, respectively). Multivariate analyses showed that a smaller increase in serum IL-6 or CRP levels at 1POD [less than 75th percentile (112.9 or 10.6 mg/ml, respectively)] was independently related to only minilaparotomy.


CONCLUSIONS
These data in this nonrandomized trial suggest that minilaparotomy may be independently associated with reduced inflammatory responses in colorectal cancer resection.
Nakagoe
T
T
First Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan. nakagoe@net.nagasaki-u.ac.jp
Tsuji
T
T
Sawai
T
T
Sugawara
K
K
Inokuchi
N
N
Kamihira
S
S
Arisawa
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000276:immunology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D015850:Interleukin-6 / Q000097:blood; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications / Q000276:immunology / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome
D015850:Interleukin-6; D002097:C-Reactive Protein