title: Intestinal permeability, systemic endotoxemia, and bacterial translocation after open or laparoscopic resection for colon cancer: a prospective randomized study.
abstract: OBJECTIVE
  In this prospective randomized study, we investigated the effect of surgery on intestinal permeability (IP), endotoxemia, and bacterial translocation (BT) in patients undergoing elective colectomy for colon cancer by comparing the laparoscopic with the open approach.
  
  
  METHODS
  Seventy-two consecutive patients underwent colectomy for colon cancer: 35 cases open resection and 37 cases laparoscopic resection. IP was measured preoperatively and at days 1 and 3 after surgery. Serial venous blood sample were taken at 0, 30, 60, 90, 120, and 180 min and at 12, 24, and 48 h after surgery for endotoxin measurement. Tissue sample were taken from the liver, spleen, and mesenteric lymph nodes and were weighed under sterile conditions.
  
  
  RESULTS
  IP was significantly increased in the open and closed group at day 1 compared with the preoperative level (p < 0.05), but no difference was found between laparoscopic and open surgery group. The concentration endotoxin systemic increased significantly in the both group during the course of surgery but returned to baseline levels at the second day 2. No difference was found between laparoscopic and open surgery. A significant correlation was observed between the maximum systemic endotoxin concentration and IP measured at D1 in the open group and in the laparoscopic group. The incidence of BT increased in laparoscopic and open group after bowel mobilization, compared with the before mobilization (p < 0.05). There was not a statistically significant difference in BT value between the two groups.
  
  
  CONCLUSIONS
  An increase in IP, systemic endotoxemia, and BT were observed during the open and laparoscopic resection for colon cancer, without significant statistically difference between the two groups.
authors.affiliation: Department of Surgery, University of L'Aquila, L'Aquila, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Schietroma
authors.forename: Beatrice
authors.initials: B
authors.lastname: Pessia
authors.forename: Francesco
authors.initials: F
authors.lastname: Carlei
authors.forename: Emanuela Marina
authors.initials: EM
authors.lastname: Cecilia
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Amicucci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000254:growth & development; D018988:Bacterial Translocation; D003110:Colonic Neoplasms / Q000382:microbiology* / Q000473:pathology / Q000601:surgery*; D019446:Endotoxemia / Q000209:etiology* / Q000382:microbiology; D004731:Endotoxins / Q000378:metabolism; D005260:Female; D006801:Humans; D007422:Intestines / Q000382:microbiology* / Q000473:pathology* / Q000601:surgery; D007792:Lactulose / Q000378:metabolism; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008353:Mannitol / Q000378:metabolism; D008875:Middle Aged; D009367:Neoplasm Staging; D010539:Permeability; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies
chemical_list: D004731:Endotoxins; D008353:Mannitol; D007792:Lactulose
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