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Comparison of the neuroendocrine and inflammatory responses after laparoscopic and abdominal hysterectomy.

Kim TK, Yoon JR - Korean J Anesthesiol (2010)

Bottom Line: Laparoscopic surgery is associated with a more favorable clinical outcome than that of conventional open surgery.The response of interleukin-6 showed a significant correlation with the response of CRP (r = 0.796; P < 0.05).The laparoscopic surgical procedure leaves the endocrine metabolic response largely unaltered as compared with that of open abdominal hysterectomy, but it reduces the inflammatory response as measured by the IL-6 and CRP levels.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Bucheon, Korea.

ABSTRACT

Background: Laparoscopic surgery is associated with a more favorable clinical outcome than that of conventional open surgery. This might be related to the magnitude of the tissue trauma. The aim of the present study was to examine the differences of the neuroendocrine and inflammatory responses between the two surgical techniques.

Methods: Twenty-four patients with no major medical disease were randomly assigned to undergo laparoscopic (n = 13) or abdominal hysterectomy (n = 11). Venous blood samples were collected and we measured the levels of interleukin-6 (IL-6), CRP and cortisol at the time before and after skin incision, at the end of peritoneum closure and at 1 h and 24 h after operation.

Results: The laparoscopic hysterectomy group demonstrated less of an inflammatory response in terms of the serum IL-6 and CRP responses than did the abdominal hysterectomy group, and the laparoscopic hysterectomy group had a shorter hospital stay (P < 0.05). The peak serum IL-6 (P < 0.05) and CRP concentrations were significantly less increased in the laparoscopic group as compared with that of the abdominal hysterectomy group (P < 0.05), while the serum cortisol concentration showed a similar time course and changes and there were no significant difference between the groups. The response of interleukin-6 showed a significant correlation with the response of CRP (r = 0.796; P < 0.05).

Conclusions: The laparoscopic surgical procedure leaves the endocrine metabolic response largely unaltered as compared with that of open abdominal hysterectomy, but it reduces the inflammatory response as measured by the IL-6 and CRP levels.

No MeSH data available.


Related in: MedlinePlus

Changes in the plasma cortisol concentration (mean ± SEM) during and after laparoscopic and abdominal hysterectomy. Measurement points: T0 = before anesthesia, T1 = after skin incision, T2 = at the end of peritoneal closure, T3 = 1 h after operation, T4 = 24 h after operation. *P < 0.05 versus the preoperative value.
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Figure 3: Changes in the plasma cortisol concentration (mean ± SEM) during and after laparoscopic and abdominal hysterectomy. Measurement points: T0 = before anesthesia, T1 = after skin incision, T2 = at the end of peritoneal closure, T3 = 1 h after operation, T4 = 24 h after operation. *P < 0.05 versus the preoperative value.

Mentions: For the serum cortisol level, the baseline serum cortisol level was no difference between the groups and the groups had similar sequential changes over time throughout the operation and 24 hr after operation. The serum cortisol level increased after the surgery started, it reached its peak level at 1 hr postoperatively in the patients undergoing abdominal hysterectomy, but it reached its peak level at the end of peritoneum closure in the patients who were undergoing laparoscopic hysterectomy. Although the serum cortisol level did not show a significant difference between the groups, more rapid decline to baseline (from 30.4 ± 7.7 µg/dl to 11.8 ± 3.6 µg/dl) after operation and from 38.0 ± 14.3 µg/dl to 18.1 ± 5.9 µg/dl in the patients who underwent abdominal hysterectomy. But there was no significant difference for this between the groups (Fig. 3).


Comparison of the neuroendocrine and inflammatory responses after laparoscopic and abdominal hysterectomy.

Kim TK, Yoon JR - Korean J Anesthesiol (2010)

Changes in the plasma cortisol concentration (mean ± SEM) during and after laparoscopic and abdominal hysterectomy. Measurement points: T0 = before anesthesia, T1 = after skin incision, T2 = at the end of peritoneal closure, T3 = 1 h after operation, T4 = 24 h after operation. *P < 0.05 versus the preoperative value.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2966708&req=5

Figure 3: Changes in the plasma cortisol concentration (mean ± SEM) during and after laparoscopic and abdominal hysterectomy. Measurement points: T0 = before anesthesia, T1 = after skin incision, T2 = at the end of peritoneal closure, T3 = 1 h after operation, T4 = 24 h after operation. *P < 0.05 versus the preoperative value.
Mentions: For the serum cortisol level, the baseline serum cortisol level was no difference between the groups and the groups had similar sequential changes over time throughout the operation and 24 hr after operation. The serum cortisol level increased after the surgery started, it reached its peak level at 1 hr postoperatively in the patients undergoing abdominal hysterectomy, but it reached its peak level at the end of peritoneum closure in the patients who were undergoing laparoscopic hysterectomy. Although the serum cortisol level did not show a significant difference between the groups, more rapid decline to baseline (from 30.4 ± 7.7 µg/dl to 11.8 ± 3.6 µg/dl) after operation and from 38.0 ± 14.3 µg/dl to 18.1 ± 5.9 µg/dl in the patients who underwent abdominal hysterectomy. But there was no significant difference for this between the groups (Fig. 3).

Bottom Line: Laparoscopic surgery is associated with a more favorable clinical outcome than that of conventional open surgery.The response of interleukin-6 showed a significant correlation with the response of CRP (r = 0.796; P < 0.05).The laparoscopic surgical procedure leaves the endocrine metabolic response largely unaltered as compared with that of open abdominal hysterectomy, but it reduces the inflammatory response as measured by the IL-6 and CRP levels.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Bucheon, Korea.

ABSTRACT

Background: Laparoscopic surgery is associated with a more favorable clinical outcome than that of conventional open surgery. This might be related to the magnitude of the tissue trauma. The aim of the present study was to examine the differences of the neuroendocrine and inflammatory responses between the two surgical techniques.

Methods: Twenty-four patients with no major medical disease were randomly assigned to undergo laparoscopic (n = 13) or abdominal hysterectomy (n = 11). Venous blood samples were collected and we measured the levels of interleukin-6 (IL-6), CRP and cortisol at the time before and after skin incision, at the end of peritoneum closure and at 1 h and 24 h after operation.

Results: The laparoscopic hysterectomy group demonstrated less of an inflammatory response in terms of the serum IL-6 and CRP responses than did the abdominal hysterectomy group, and the laparoscopic hysterectomy group had a shorter hospital stay (P < 0.05). The peak serum IL-6 (P < 0.05) and CRP concentrations were significantly less increased in the laparoscopic group as compared with that of the abdominal hysterectomy group (P < 0.05), while the serum cortisol concentration showed a similar time course and changes and there were no significant difference between the groups. The response of interleukin-6 showed a significant correlation with the response of CRP (r = 0.796; P < 0.05).

Conclusions: The laparoscopic surgical procedure leaves the endocrine metabolic response largely unaltered as compared with that of open abdominal hysterectomy, but it reduces the inflammatory response as measured by the IL-6 and CRP levels.

No MeSH data available.


Related in: MedlinePlus