Laparoscopic versus open colorectal surgery for colon cancer: the effect of surgical trauma on the bacterial translocation. A prospective randomized study.
BACKGROUND
Several studies suggest that surgical manipulation of the intestine and increased intra-abdominal pressure promotes bacterial translocation (BT). This prospective randomized study has investigated the effect of surgery on BT in patients undergoing elective colectomy for colon cancer by comparing the laparoscopic with the open approach.


METHODS
One hundred nineteen consecutive patients underwent colectomy for colon cancer: 59 cases underwent open resection and 60 cases underwent laparoscopic resection. For bacterial identification, tissue samples were taken from the liver, spleen, and mesenteric lymph nodes.


RESULTS
The incidence of BT increased in laparoscopic and open group after bowel mobilization (prior to ligation of the vascular pedicle), compared with the before mobilization (P < .05). There was not a statistically significant difference in BT value between the 2 groups.


CONCLUSIONS
BT increase was observed during the open and laparoscopic resection for colon cancer, without significant statistical difference between the 2 groups.
Department of Surgery, Hospital San Salvatore, University of L'Aquila, L'Aquila, Italy.
Mario
M
Schietroma
Department of Surgery, Hospital San Salvatore, University of L'Aquila, L'Aquila, Italy. Electronic address: pessiabeatrice87@gmail.com.
Beatrice
B
Pessia
Department of Surgery, Hospital San Salvatore, University of L'Aquila, L'Aquila, Italy.
Francesco
F
Carlei
Department of Surgery, Hospital San Salvatore, University of L'Aquila, L'Aquila, Italy.
Emanuela Marina
EM
Cecilia
Department of Surgery, Hospital San Salvatore, University of L'Aquila, L'Aquila, Italy.
Giuseppe
G
De Santis
Department of Surgery, Hospital San Salvatore, University of L'Aquila, L'Aquila, Italy.
Gianfranco
G
Amicucci
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018988:Bacterial Translocation; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013312:Stress, Physiological
Bacterial translocation; Colon cancer; Intestinal permeability; Laparoscopy