title: A prospective, randomized comparison of pain, inflammatory response, and short-term outcomes between single port and laparoscopic cholecystectomy.
abstract: BACKGROUND
  The purpose of this study was to compare the postoperative inflammatory response and severity of pain between single-incision laparoscopic surgery (SILS) cholecystectomy and conventional laparoscopic cholecystectomy (LC).
  
  
  METHODS
  Two groups of 20 patients were prospectively randomized to either conventional LC or SILS cholecystectomy. Serum interleukin-6 (IL-6) levels were assayed before surgery, at 4-6 h, and at 18-24 h after the procedure. Serum C-reactive protein (CRP) levels also were assayed at 18-24 h after surgery. Pain was measured at each of three time points after surgery using the visual analogue scale (VAS). The number of analgesia doses administered in the first 24 h after the procedure also was recorded and 30-day surgical outcomes were documented.
  
  
  RESULTS
  The groups had equivalent body mass index (BMI), age, and comorbidity distribution. Peak IL-6 levels occurred 4-6 h after surgery, and the median level was 12.8 pg/ml in the LC and 8.9 pg/ml in the SILS group (p = 0.5). The median CRP level before discharge was 1.6 mg/dl in the LC and 1.9 mg/dl in the SILS group (p = 0.38). There was no difference in either analgesic use or pain intensity as measured by the VAS between the two groups (p = 0.72). The length of the surgical procedure was significantly longer in the SILS group (p < 0.001). No intraoperative complications occurred in either group.
  
  
  CONCLUSIONS
  Single-incision laparoscopic surgery does not significantly reduce systemic inflammatory response, postoperative pain, or analgesic use compared with LC.
authors.affiliation: Second Clinics of General Surgery, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil. lunare@ohsu.edu
authors.forename: Renato A
authors.initials: RA
authors.lastname: Luna
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Nogueira
authors.forename: Pablo S
authors.initials: PS
authors.lastname: Varela
authors.forename: Eduardo de O
authors.initials: Ede O
authors.lastname: Rodrigues Neto
authors.forename: Maria Júlia R
authors.initials: MJ
authors.lastname: Norton
authors.forename: Luciana do Carmo B
authors.initials: Ldo C
authors.lastname: Ribeiro
authors.forename: Agatha M
authors.initials: AM
authors.lastname: Peixoto
authors.forename: Yara L
authors.initials: YL
authors.lastname: de Mendonça
authors.forename: Isidro
authors.initials: I
authors.lastname: Bendet
authors.forename: Rossano A
authors.initials: RA
authors.lastname: Fiorelli
authors.forename: James P
authors.initials: JP
authors.lastname: Dolan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult