Adipocytokine: a new family of inflammatory and immunologic markers of invasiveness in major urologic surgery.
BACKGROUND
Laparoscopic surgery has been proposed to reduce surgical trauma and diminish patients' stress response.


OBJECTIVE
To investigate the role of the adipocytokine, in combination with changes in other known inflammatory markers, in patients undergoing radical prostatectomy.


METHODS
A total of 580 patients were enrolled in this prospective study. Laparoscopic extraperitoneal radical prostatectomy (LRP) was performed in 286 patients, and open retropubic radical prostatectomy (RRP) in 294 patients.


METHODS
Blood samples were collected preoperatively and up to 5 d postoperatively.


METHODS
Serum concentrations of acute phase markers, interleukins (IL), and the adipocytokine leptin were measured at each time point by means of enzyme-linked immunosorbent assay. Clinical data were collected and analysed.


CONCLUSIONS
Patients undergoing LRP had significantly lower IL-6 and adipocytokine levels at all measurement time points. However, biphasic kinetics of adipocytokine serum levels were observed during the postoperative course in all patients. LRP was associated with less adipocytokine and IL-6 release, indicating a smaller degree of surgical insult and the minimal invasive nature of this procedure. The limitation of this study was its nonrandomised design.


CONCLUSIONS
Adipocytokines might serve as additional immunologic markers of invasiveness in major urologic surgery.
Greco
Francesco
F
Clinic for Urology and Kidney Transplantation Centre, Martin Luther University Medical School of Halle/Saale, Germany. francesco.greco@medizin.uni-halle.de
Hoda
M Raschid
MR
Wagner
Sigrid
S
Reichelt
Olaf
O
Inferrera
Antonino
A
Fischer
Kersten
K
Fornara
Paolo
P
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000276:immunology; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000276:immunology / Q000601:surgery*; D000685:Serum Amyloid A Protein / Q000378:metabolism
D015415:Biomarkers; C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D020738:Leptin; C521404:SAA1 protein, human; D000685:Serum Amyloid A Protein; D016753:Interleukin-10; D002097:C-Reactive Protein