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Erschienen in: Surgical Endoscopy 5/2012

01.05.2012

Systemic inflammatory response after laparoscopic and conventional colectomy for cancer: a matched case–control study

verfasst von: Dimitrios Tsamis, George Theodoropoulos, Paraskevas Stamopoulos, Spyridon Siakavellas, Thalassini Delistathi, Nikolaos V. Michalopoulos, George C. Zografos

Erschienen in: Surgical Endoscopy | Ausgabe 5/2012

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Abstract

Background

Studies dealing with laparoscopic colectomy for cancer have reached conflicting results in regards to various inflammatory cytokines. Most of them have not examined potential differences with the open procedures at later postoperative days, when the immunologic advantage of laparoscopic surgery would be more demanding to demonstrate (for earlier administration of adjuvant treatment). The aim of this work is to detect differences of proinflammatory cytokines between conventional and laparoscopic colectomy for cancer.

Patients and methods

30 patients who underwent laparoscopic colectomy were age, sex, and preoperative stage-matched with 30 patients treated by open surgery. C-reactive protein (CRP), interleukin (IL)-1, -6, and -8, and interferon (IFN)-γ serum levels were measured preoperatively, at 24 h, and at the 7th postoperative day (POD).

Results

CRP and IL-6 postoperative values (24 h and 7th POD) were significantly higher than baseline for both groups (p = 0.001), but the respective values at the 7th POD were less than at 24 h (p = 0.001). IL-1 and -8 levels did not show any differences between assessment timepoints. A higher IFN-γ measurement was demonstrated at 24 h compared with baseline for the laparoscopic group only (p = 0.03). This difference was not maintained at the 7th POD. IFN-γ levels at 24 h and the 7th POD were significantly less for the open compared with the laparoscopic group of patients (p = 0.001). No correlation was revealed between measured serum values and age, sex, tumor location, or stage.

Conclusions

This matched case–control study verifies the already reported lack of differences regarding IL-1. Controversy still exists on likely IL-6 differences. The inadequately studied IL-8 does not seem to play an important role in immunologic differences. The immunologically beneficial IFN-γ, produced by the principal effectors of cell-mediated immunity Th1 cells, seems to have a more active presence following laparoscopic colectomy, potentially contributing to an immunologic “advantage” by counteracting “harmful” cytokines, such as IL-1.
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Metadaten
Titel
Systemic inflammatory response after laparoscopic and conventional colectomy for cancer: a matched case–control study
verfasst von
Dimitrios Tsamis
George Theodoropoulos
Paraskevas Stamopoulos
Spyridon Siakavellas
Thalassini Delistathi
Nikolaos V. Michalopoulos
George C. Zografos
Publikationsdatum
01.05.2012
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 5/2012
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-011-2052-z

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Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.