Inflammatory Response After Laparoscopic Versus Open Resection of Colorectal Liver Metastases: Data From the Oslo-CoMet Trial.
Laparoscopic and open liver resection have not been compared in randomized trials. The aim of the current study was to compare the inflammatory response after laparoscopic and open resection of colorectal liver metastases (CLM) in a randomized controlled trial.This was a predefined exploratory substudy within the Oslo CoMet-study. Forty-five patients with CLM were randomized to laparoscopic (n = 23) or open (n = 22) resection. Ethylenediaminetetraacetic acid-plasma samples were collected preoperatively and at defined time points during and after surgery and snap frozen at -80 C. A total of 25 markers were examined using luminex and enzyme-linked immunosorbent assay techniques: high-mobility box group 1(HMGB-1), cell-free DNA (cfDNA), cytokines, and terminal C5b-9 complement complex complement activation.Eight inflammatory markers increased significantly from baseline: HMGB-1, cfDNA, interleukin (IL)-6, C-reactive protein, macrophage inflammatory protein -1β, monocyte chemotactic protein -1, IL-10, and terminal C5b-9 complement complex. Peak levels were reached at the end of or shortly after surgery. Five markers, HMGB-1, cfDNA, IL-6, C-reactive protein, and macrophage inflammatory protein -1β, showed significantly higher levels in the open surgery group compared with the laparoscopic surgery group.Laparoscopic resection of CLM reduced the inflammatory response compared with open resection. The lower level of HMGB-1 is interesting because of the known association with oncogenesis.
From the Intervention Centre (AAF, NP, AMK, SEP, BE); Department of HPB surgery (AAF, BAB, BE); Department of Immunology, Oslo University Hospital, Oslo (AS, PHN, INR, TEM); Institute of Clinical Medicine (AAF, AMK, BE), University of Oslo, Oslo; Department of Surgery, Finnmark Hospital, Kirkenes (AMK); Division of Emergencies and Critical Care (SEP); Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo (MWF); Research Laboratory, Nordland Hospital, Bodo, and Faculty of Health Sciences, University of Tromso (TEM); and Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway (TEM).
Aasmund Avdem
AA
Fretland
Andrey
A
Sokolov
Nadya
N
Postriganova
Airazat M
AM
Kazaryan
Soren E
SE
Pischke
Per H
PH
Nilsson
Ingrid Nygren
IN
Rognes
Bjorn Atle
BA
Bjornbeth
Morten Wang
MW
Fagerland
Tom Eirik
TE
Mollnes
Bjorn
B
Edwin
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D054407:Chemokine CCL4 / Q000097:blood; D015179:Colorectal Neoplasms / Q000473:pathology*; D015938:Complement Membrane Attack Complex / Q000032:analysis; D005260:Female; D024243:HMGB1 Protein / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000209:etiology; D018836:Inflammation Mediators / Q000097:blood*; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged
D054407:Chemokine CCL4; D015938:Complement Membrane Attack Complex; D024243:HMGB1 Protein; C585491:HMGB1 protein, human; D018836:Inflammation Mediators; D002097:C-Reactive Protein