title: Surgical stress after open and transumbilical laparoscopic-assisted appendectomy in children.
abstract: BACKGROUND
  The transumbilical laparoscopic-assisted appendectomy (TULAA) effects on the surgical stress response in children have not been studied. Our aim is to investigate the stress response in TULAA.
  
  
  METHODS
  A total of 35 children underwent the appendectomy by open approach (OA) or TULAA approach. Interleukins (ILs)-6, -18, and -10 were measured before (T0), at the beginning (T1a), and at the end of surgery (T1b) and 24 hours after (T2).
  
  
  RESULTS
  An increase in IL-6 levels at T1b and T2 and in IL-18 at T2 was observed after OA. A significant increase of both IL-6 and IL-18 were observed at T2 but values were less compared with OA (11.6 ± 4.4 vs. 31.9 ± 8.9 pg/mL for IL-6, p = 0.0006; 145.6 vs. 174.9 pg/mL for IL-18, p = NS).
  
  
  CONCLUSIONS
  A significant reduction in the postoperative cytokines in TULAA group suggests that this approach causes less surgical trauma in children.
authors: Angela Simona
authors: AS
authors: Montalto
authors: Unit of Pediatric Surgery, Department of Pediatrics, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.
authors: Angela
authors: A
authors: Simona
authors: Pietro
authors: P
authors: Impellizzeri
authors: Unit of Genetic and Pediatric Immunology, Department of Pediatric, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.
authors: Maria
authors: M
authors: Grasso
authors: Unit of Pediatric Surgery, Department of Pediatrics, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.
authors: Pietro
authors: P
authors: Antonuccio
authors: Unit of Anesthesiology, University of Messina, Messina, Italy.
authors: Caterina
authors: C
authors: Crisafi
authors: Unit of Pediatric Surgery, Department of Pediatrics, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.
authors: Gianfranco
authors: G
authors: Scalfari
authors: Unit of Pediatric Surgery, Department of Pediatrics, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.
authors: Francesco
authors: F
authors: Arena
authors: Unit of Genetic and Pediatric Immunology, Department of Pediatric, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.
authors: Carmelo
authors: C
authors: Salpietro
authors: Unit of Pediatric Surgery, University of Bologna, Bologna, Italy.
authors: Mario
authors: M
authors: Lima
authors: Unit of Pediatric Surgery, Department of Pediatrics, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.
authors: Carmelo
authors: C
authors: Romeo
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000009:adverse effects* / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D020382:Interleukin-18 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D011446:Prospective Studies; D013312:Stress, Physiological; D013997:Time Factors
chemical_list: D020382:Interleukin-18; D015850:Interleukin-6; D016753:Interleukin-10