Systemic and peritoneal angiogenic response after laparoscopic or conventional colon resection in cancer patients: a prospective, randomized trial.
OBJECTIVE
Angiogenesis is essential for wound healing. Vascular endothelial growth factor and endostatin are both endogenous angiogenic factors thought to be involved in the initiation and termination of angiogenesis. The aim of this study was to assess the local and systemic angiogenic profile in patients undergoing laparoscopic or open surgery for colon cancer.


METHODS
Patients with primary colon carcinoma were prospectively randomized to curative laparoscopic (n = 12) or conventional (n = 14) resection. Vascular endothelial growth factor and endostatin levels in serum and wound fluid were investigated.


RESULTS
In both groups vascular endothelial growth factor levels in wound fluid were significantly higher than postoperative serum levels, whereas endostatin levels in wound fluid were lower than serum levels and decreased progressively after surgery. The vascular endothelial growth factor levels in wound fluid measured at Day 4 were significantly higher in the laparoscopy group than in the laparotomy patients.


CONCLUSIONS
Wound healing is associated with a strong local increase in pro-angiogenic factors and a decrease in antiangiogenic factors. The investigation of locally produced factors offered greater insight into the process of angiogenesis during wound healing than could be acquired from the circulation.
Wu
F P K
FP
Department of Surgery, VU Medisch Centrum, Amsterdam, The Netherlands.
Hoekman
K
K
Sietses
C
C
von Blomberg
B M E
BM
Meijer
S
S
Bonjer
H J
HJ
Cuesta
M A
MA
D000368:Aged; D003110:Colonic Neoplasms / Q000601:surgery*; D043169:Endostatins / Q000097:blood; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D011446:Prospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D014945:Wound Healing
D043169:Endostatins; D042461:Vascular Endothelial Growth Factor A