Influence of open versus laparoscopically assisted colectomy on soluble vascular endothelial growth factor (sVEGF) and its soluble receptor 1 (sVEGFR1).
BACKGROUND
Minimal invasive colectomy may attenuate surgery-induced immunomodulation. This may in part be due to a reduced postoperative inflammation-mediated angiogenic stimulus directed by the proangiogenic factor VEGF and its neutralizing receptor VEGFR1. Thus, we evaluated perioperative plasma concentrations of soluble VEGF (sVEGF) and soluble VEGFR1 (sVEGFR1) in patients undergoing elective colectomy.


METHODS
60 consecutive patients were randomized to undergo laparoscopically assisted or open right or left sided colectomy. Blood samples were drawn preoperatively, intraoperatively and postoperatively until 30 days after the operation. Commercially available ELISA methods were used for determination of sVEGF and sVEGFR1.


RESULTS
Patients with cancer (n = 48) had higher preoperative levels of sVEGF compared to patients with benign disease (n = 12) (p = 0.04), while there was no significant difference in sVEGFR1 levels (p = 0.053). Soluble VEGF (p < 0.0001) and sVEGFR1 (p < 0.0001) levels fluctuated intra- and postoperatively. However, the intra- and postoperative levels of sVEGF and sVEGFR1 were similar at all time points in patients undergoing laparoscopically assisted or open resection.


CONCLUSIONS
Although significant fluctuation in sVEGF and sVEGFR1 concentrations during the perioperative period was shown, patients who underwent laparoscopically assisted resection had similar levels as patients who underwent open resection.
Svendsen
M N
MN
Department of Surgical Gastroenterology 435, Hvidovre University Hospital, 2650, Hvidovre, Denmark. madsnsvendsen@hotmail.com
Werther
K
K
Christensen
I J
IJ
Basse
L
L
Nielsen
H J
HJ
D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia; D000758:Anesthesia; D003082:Colectomy; D003110:Colonic Neoplasms / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D040262:Receptors, Vascular Endothelial Growth Factor / Q000097:blood*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
D042461:Vascular Endothelial Growth Factor A; D040262:Receptors, Vascular Endothelial Growth Factor