title: Early post-operative interleukin-6 and tumor necrosis factor-α levels after single-port laparoscopic varicocelectomy in children.
abstract: OBJECTIVE
  Laparoendoscopic single-site surgery has recently been described in children and regarded as an improved technology leading to less pain and better cosmetic outcome. Compared to the traditional three-port method, it is not known if the single-port method is less invasive. The aim of this study was thus to investigate the post-operative acute inflammatory response in order to evaluate surgical stress in the two surgical approaches in children.
  
  
  METHODS
  A prospective, single blinded, case-control study was carried out. Thirteen male patients who presented with unilateral varicocele were divided into two groups. Six children underwent single-port laparoscopic procedure, while the other seven children underwent three-port laparoscopic procedure. Pre-operative and post-operative blood samples were taken for the measurement of tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) using ELISA. Demographics including the operation time, and complications were recorded. Data between the two groups were analyzed using unpaired t-test and a p value of <0.05 was taken as statistically significant.
  
  
  RESULTS
  The mean age of patients was 14.5 years (range 12-19 years). There was no significant difference between the two groups in terms of operative time, nor there was any complication recorded. The change in serum TNF-α and IL-6 concentrations pre- and post-operatively between the single-port group and three-port group was not statistically significant. Overall, patients in the two groups showed excellent satisfaction in terms of post-operative cosmesis.
  
  
  CONCLUSIONS
  Single-port laparoscopic varicocelectomy is safe, effective and produces excellent cosmesis with minimal surgical stress.
authors: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR, China.
authors: Wei
authors: W
authors: Hao
authors: Ivy H Y
authors: IH
authors: Chan
authors: Xuelai
authors: X
authors: Liu
authors: Paula M Y
authors: PM
authors: Tang
authors: Paul K H
authors: PK
authors: Tam
authors: Kenneth K Y
authors: KK
authors: Wong
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D013312:Stress, Physiological / Q000502:physiology*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D013521:Urologic Surgical Procedures, Male / Q000295:instrumentation*; D014646:Varicocele / Q000097:blood / Q000175:diagnosis / Q000601:surgery*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha