title: Systemic inflammatory response after laparoscopic and conventional colectomy for cancer: a matched case-control study.
abstract: BACKGROUND
  Studies dealing with laparoscopic colectomy for cancer have reached conflicting results in regards to various inflammatory cytokines. Most of them have not examined potential differences with the open procedures at later postoperative days, when the immunologic advantage of laparoscopic surgery would be more demanding to demonstrate (for earlier administration of adjuvant treatment). The aim of this work is to detect differences of proinflammatory cytokines between conventional and laparoscopic colectomy for cancer.
  
  
  METHODS
  30 patients who underwent laparoscopic colectomy were age, sex, and preoperative stage-matched with 30 patients treated by open surgery. C-reactive protein (CRP), interleukin (IL)-1, -6, and -8, and interferon (IFN)-γ serum levels were measured preoperatively, at 24 h, and at the 7th postoperative day (POD).
  
  
  RESULTS
  CRP and IL-6 postoperative values (24 h and 7th POD) were significantly higher than baseline for both groups (p = 0.001), but the respective values at the 7th POD were less than at 24 h (p = 0.001). IL-1 and -8 levels did not show any differences between assessment timepoints. A higher IFN-γ measurement was demonstrated at 24 h compared with baseline for the laparoscopic group only (p = 0.03). This difference was not maintained at the 7th POD. IFN-γ levels at 24 h and the 7th POD were significantly less for the open compared with the laparoscopic group of patients (p = 0.001). No correlation was revealed between measured serum values and age, sex, tumor location, or stage.
  
  
  CONCLUSIONS
  This matched case-control study verifies the already reported lack of differences regarding IL-1. Controversy still exists on likely IL-6 differences. The inadequately studied IL-8 does not seem to play an important role in immunologic differences. The immunologically beneficial IFN-γ, produced by the principal effectors of cell-mediated immunity Th1 cells, seems to have a more active presence following laparoscopic colectomy, potentially contributing to an immunologic "advantage" by counteracting "harmful" cytokines, such as IL-1.
authors.affiliation: 1st Department of Propaedeutic Surgery, Hippokrateion General Hospital, Athens Medical School, University of Athens, Athens, Greece. tsamisdim@hotmail.com
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsamis
authors.forename: George
authors.initials: G
authors.lastname: Theodoropoulos
authors.forename: Paraskevas
authors.initials: P
authors.lastname: Stamopoulos
authors.forename: Spyridon
authors.initials: S
authors.lastname: Siakavellas
authors.forename: Thalassini
authors.initials: T
authors.lastname: Delistathi
authors.forename: Nikolaos V
authors.initials: NV
authors.lastname: Michalopoulos
authors.forename: George C
authors.initials: GC
authors.lastname: Zografos
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003082:Colectomy / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000601:surgery*; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*
chemical_list: D016207:Cytokines; D002097:C-Reactive Protein