title: Length of laparotomy incision and surgical stress assessed by serum IL-6 level.
abstract: BACKGROUND
  Because surgical stress is thought to have an effect on morbidity, mortality, and remnant tumour progression after surgery, diminishing surgical stress is important. The purpose of this study was to assess in a murine model whether the length and type of laparotomy incision influence surgical stress.
  
  
  METHODS
  Serum IL-6 concentrations were measured sequentionally in 220 male BALB/c mice who were assigned to different basic laparotomies, (1-cm versus 2-cm versus 3-cm laparotomy with or without caecal resection), other types of laparotomy (3-cm, 1-cm x 3, 3-cm transverse, 3-cm laparotomy with rapid closure), or 3-cm skin incision with or without laparotomy. The serum level of IL-6 was measured by ELISA.
  
  
  RESULTS
  Serum IL-6 levels at 3 and 6h after surgery were significantly higher in the 3-cm laparotomy group (1,680+/-802pg/ml and 1,066+/-507pg/ml, respectively), than in the 1-cm laparotomy group (797+/-427pg/ml and 515+/-212pg/ml, respectively). When caecal resection was added, the serum IL-6 level at 6h was significantly higher in the 3-cm laparotomy group (2,844+/-134pg/ml) than in the 1-cm laparotomy group (2,200+/-379pg/ml). Although the type of laparotomy incision was not associated with the serum level of IL-6, the serum IL-6 level after midline skin incision without laparotomy (245+/-142pg/ml) was significantly lower than that after 3-cm laparotomy (1,680+/-802pg/ml).
  
  
  CONCLUSIONS
  The length of laparotomy incision was correlated with the serum level of IL-6 in a murine model. The surgical stress related to abdominal procedures might be decreased when laparotomy wounds are kept as small as possible.
authors.affiliation: Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Oita 879-5593, Japan. geka1@med.oita-u.ac.jp
authors.forename: Shozo
authors.initials: S
authors.lastname: Ishibashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Kyuzo
authors.initials: K
authors.lastname: Fujii
authors.forename: Norio
authors.initials: N
authors.lastname: Shiraishi
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Adachi
authors.forename: Seigo
authors.initials: S
authors.lastname: Kitano
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D007431:Intraoperative Complications / Q000517:prevention & control*; D007813:Laparotomy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D011183:Postoperative Complications / Q000517:prevention & control
chemical_list: D015415:Biomarkers; D015850:Interleukin-6